AMCNO Attends First Meeting of Ohio House Healthcare Efficiencies Study Committee

The Academy of Medicine of Cleveland & Northern Ohio (AMCNO) was on hand at the first meeting of the Ohio House Healthcare Efficiencies Study Committee, chaired by Rep. Stephen Huffman (R-Tipp City). The purpose of this study committee is to examine healthcare efficiencies that lead to better health outcomes at a lower cost to Ohioans. Speaker Cliff Rosenberger (R-Clarksville) created this committee to examine healthcare models across Ohio that the House can help support and promote. The findings of the committee could potentially be used in legislation to be introduced later in the General Assembly.

This first meeting of the committee focused on graduate medical education (GME) funding in Ohio. Rep. Huffman, a physician, said it’s important to understand the educational process that medical professionals go through as lawmakers consider legislation that aims to keep graduates in the state and intend to work in underserved areas.

Several physicians testified before the committee outlining why maintaining GME funding is important to the state. Testimony addressed how GME works—with both federal and state funds used by teaching hospitals to pay for the cost of educating residents through direct GME payments, which reimburse hospitals for the costs of salaries and benefits paid to residents and teaching faculty; and indirect GME payments, which are added on to patient care reimbursement rates to compensate teaching hospitals. Testimony also addressed how Medicare and Medicaid reimburse teaching hospitals for their direct and indirect shares for training residents—with additional information provided on how Ohio Medicaid pays hospitals for the percentage of GME costs. 

All of the panel presenters mentioned the physician shortage in Ohio, particularly primary care physicians.

It was noted that several factors could worsen the impact of the physician shortage in the future, such as the aging of the baby boomer population, the increase in the newly insured due to the Medicaid expansion, and population growth.  In order to address this impending shortage, Ohio medical school enrollment has increased more than 15% in recent years; however, residency slots have not increased. This trend has resulted in more medical students graduating from Ohio schools, but failing to find a residency spot.

Several suggestions were provided to the committee by the panelists that could address these issues, including using GME dollars to incentivize the production of the kinds of physicians needed now and into the future; distributing GME dollars based on outpatient services as well as inpatient services; creating an Ohio GME advisory entity; having the state fund residencies in non-academic settings to promote new delivery models of care; adding residency slots in fields that met workforce demands, and tying GME funding to performance metrics. 

This meeting was the first of four meetings scheduled for the Ohio House Healthcare Efficiencies Study Committee. The next three meetings are scheduled in various parts of the state through the middle of September. The focus of the next three meetings will be on behavioral health, Medicaid and aging, children’s health, innovative medical savings, and population health management. As noted above, the findings of the committee could potentially be used in legislation to be introduced later in the General Assembly. 



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