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Medicaid Graduate Medical Education Payments: Results From the 2018 50-State Survey

Year Published: 2019
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Medicaid Graduate Medical Education Payments: Results From the 2018 50-State Survey

The associated costs behind Medicaid graduate medical education payments can be a mystery to hospital leadership and policymakers. This 50-state survey gets to the bottom of the 2018 data, helping highlight state and national Medicaid funding trends in a digestible, reader-friendly way.

Medicaid Graduate Medical Education Payments: Results From the 2018 50-State Survey
Year Published: 2019
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Designed for officials, policymakers, health care advocates, and anyone seeking comprehensive information on Medicaid graduate medical education payments.



Government support for graduate medical education (GME) is vital to continuing to train the next generation of physicians. Behind Medicare, Medicaid is the second largest explicit source of funding for GME and the other special missions and services of America’s teaching hospitals.

This report highlights state and national Medicaid funding trends and includes insights critical to strategic and tactical planning within teaching hospitals.

Key findings include the following:

  • Medicaid support for GME continues to grow, with 43 states, including the District of Columbia, providing $5.58 billion in funding.
  • About half of the states providing support provided both direct graduate medical education (DGME) and indirect medical education (IME) payments.
  • The most common source of financing for this support was state general revenue, followed by local government contributions.
  • Payments made under managed care continue to exceed the proportion of payments made for fee-for-service, a trend that began in 2015.
  • Some states pay physicians directly, and others include non-MD professions.
  • Accountability is increasingly a factor for policymakers and stakeholders. In 2018, 35 states collected data on the DGME costs of teaching programs, and 14 states routinely audited their GME payments to teaching programs. Three states documented the impact of Medicaid GME payments on their health care workforce.


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Edition: N/A ISBN: N/A Number of Pages: 46 Year Published: 2019