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Medicaid Graduate Medical Education Payments: Results from the 2022 50-State Survey

Year Published: 2023
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Medicaid Graduate Medical Education Payments: Results from the 2022 50-State Survey

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.

Medicaid Graduate Medical Education Payments: Results from the 2022 50-State Survey
Year Published: 2023
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Overview:

DESIGNED FOR

Designed for officials, policymakers, health care advocates, and anyone seeking comprehensive information on Medicaid graduate medical education payments.

 

OVERVIEW AND BENEFITS

Government Designed for 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 Highlights:

  •  Forty-four states, including the district, made GME payments under their Medicaid program in 2022, an increase of one state from 2018. One of the seven states that did not make Medicaid GME payments, Massachusetts, is among the 10 states with the highest number of physician residents.
  • In 2022, federal and state Medicaid payments for GME nationwide continued to grow, reaching nearly $7.39 billion.
  • Twenty-four states that made Medicaid GME payments in 2022 recognized the costs of both direct graduate medical education (DGME) and indirect medical education (IME). About 60% of these states’ payments were for IME costs.
  • Under Medicaid fee-for-service, 41 states (including the district) reported making GME payments in 2022, equaling the number of states that have reported making such payments since 2009. Most of these states (32) used supplemental payments as the primary means of distribution.
  • Twenty-seven of the 41 states (including the district) that have risk-based Medicaid managed care programs made GME payments in 2022 under managed care. Eighteen of the 27 states (including the district) made GME payments explicitly and directly to teaching hospitals; 12 states recognized and included such payments in managed care organization (MCO) capitation rates. Three states made GME payments using both forms of distribution.
  • In 2022, the proportion of Medicaid GME payments made under managed care (57%) continued to exceed the proportion of such payments made under fee-for-service (43%), a trend that began in 2015.
  • Although teaching hospitals were the predominant recipient of Medicaid GME support, 11 states also made GME payments directly to other teaching providers, including community-based health centers with approved training programs, medical schools, and teaching physicians. In addition, 12 states made GME payments that cover the training of health professionals other than physician residents.

 

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Number of Pages: 58 Year Published: 2023