Continue GME Expansion to Meet State’s Physician Workforce Needs, TMA Tells CMS
By Sean Price

After more than two and a half decades, Congress has – by a modest amount – expanded the number of graduate medical education (GME) positions funded by Medicare. A recent Texas Medical Association letter to the Centers for Medicare & Medicaid Services (CMS) called on the agency to implement the change while keeping Texas and future GME expansion in mind. 

In a June 25 letter, TMA President E. Linda Villarreal, MD, noted that the Consolidated Appropriations Act of 2021 – a $2.3 billion law designed mainly to stimulate the U.S. economy – ended a 25-year freeze on Medicare-funded GME positions by adding 1,000 new slots nationwide for 2022. 

TMA applauded the addition of these badly needed GME positions but noted the new law in effect funds just 200 new positions per year across 50 states and “will likely have minimal impact, particularly after a 25-year wait,” Dr. Villarreal wrote.

TMA also expressed concern that Texas had not been deemed eligible for the redistribution of unused GME slots in prior years. That indicates Texas might not receive any of the 1,000 new GME positions, says Marcia Collins, TMA associate vice president for medical education.

Texas has made up for the U.S. freeze in Medicare-funded GME positions in part by funding new positions at the state level. For the 2022-23 biennium, the state’s GME Expansion Grant program increased funding by 27% for a total of $199.1 million, according to Stacey Silverman, PhD, assistant commissioner of the Texas Higher Education Coordinating Board.

The improved funding should maintain existing residency positions and pay for about 50 new first-year residency slots statewide through the next biennium, Dr. Silverman says. 

Between 2014 and 2021, the state helped fund 4,173 positions, including 410 first-year positions, Ms. Collins says.

Texas also has been highly successful in recruiting and retaining physicians, but this success has not kept up with the state’s rapid population growth, Dr. Villarreal wrote.

“Texas physicians ask for your help in identifying future opportunities to grow the GME capacity at a level commensurate with medical school enrollment growth and at sufficient levels to train the number of new physicians required to meet our nation’s growing needs for medical care,” she said in the letter to CMS.

Last Updated On

July 02, 2021

Originally Published On

July 02, 2021