Starting A New Osteopathic GME Program

1. Starting A New Osteopathic GME Program

2. The AOA • Professional Association Representing 100,000 Osteopathic Physicians & Osteopathic Medical Students • Primary Certifying Body for DOs • Accrediting Agency for Osteopathic GME, Colleges of Osteopathic Medicine, Hospitals & Other Health Care Facilities

3. Osteopathic Medicine • Founded in 1874 by Andrew Taylor Still, MD, DO • Focused on the Whole Person - Unity of Mind, Body, Spirit - Structure Influences Function - Innate Ability of the Body to Health Itself

4. Osteopathic GME • Primary Care Focus + Medical & Surgical Specialties • Community-Based Clinical Education • 1 in 5 Medical Students now attends a College of Osteopathic Medicine • Osteopathic Medicine is One of the Fastest Growing Health Professions

5. OGME Development Initiative A Ready Source of Information and Expert Assistance for Starting an Osteopathic Graduate Medical Education Program in Your Hospital

6. Trends Affecting Hospitals • Physician Workforce Shortages • New Colleges of Osteopathic Medicine & Medical Schools • Increasing Number of Medical Graduates • Increased Interest in Starting GME Programs = New Hospital Opportunities

7. What Keeps CEOs Up at Night • Competition for Well-Reimbursed Patient Services • Increased Cost of Physician Services • Emphasis on Cost Containment • Quality Oversight/Ties to Payment • Shortage of Skilled Healthcare Workers • Shortage of Physicians – Especially Primary Care Physicians

8. Benefits of GME • Hospital Benefits • Medical Staff Benefits • Recruiting Benefits • Patient Care Benefits • Bottom Line Benefits

9. Hospital Benefits • Physician Recruiting • Culture of Education • In-House Physician Coverage • Educational & Technical Expertise • Enhanced Service to the Community • Competitive Advantage • Revenue Stream

10. Medical Staff Benefits • Environment of Life-Long Learning • Expanded Referral Network • Prestige in the Community • Tighter Bonds Among Medical Staff & Among Attendings, House Staff & Nursing • Enhanced CME Opportunities • Succession Planning • Mentoring & Molding Future Physicians

11. Recruiting Benefits • Ability to “Grow Your Own” Medical Staff • Reduced Physician Recruiting Expenses • Caliber of Training is a Known Quantity • Trainees are Already Known & At Home in the Community • Interns & Residents Tend to Remain in the Area Where They Train

12. Patient Care Benefits • Access to Care • Enhanced Coverage & Quality • Enhanced Ability to Meet Community Needs • Expanded Scope of Services • Presence of Residents 24/7 • More Patient Contact with Physicians • Increased Comfort Level for Nursing • Opportunity for Clinical Trials & Research

13. Bottom Line Benefits • Medicare Direct & Indirect GME Payments • Reduced Medical Staff Coverage Expenses • Increase in Physician Referral Base • Financial Support also may be available from Medicaid, the Veterans Administration & Other Federal or State Programs

14. A Word about Costs Start-Up Costs Include: • Resident Salaries & Benefits • Faculty Salaries - DME & Program Director(s) - Inpatient & Ambulatory Teaching Faculty - Support Staff • Certain Capital & Equipment Costs (e.g., call rooms, library, computers, resident lounge)

15. A Word about Payment Medicare Pays Teaching Hospitals - • Direct Graduate Medical Education (DGME) Payments • Indirect Medical Education (IME) Adjustment Based on Formulas, Statutory Factors & Certain Hospital-Specific Data

16. DGME Payment • Payment for Medicare’s Share of the Costs of Training Interns & Residents - Resident Salaries & Benefits - Faculty Compensation - Program Administration & Overhead Costs • Calculated using Hospital-Specific Per Resident Amount, Medicare Utilization Rate & Number of Full Time Equivalent Residents

17. IME Adjustment • Recognizes Teaching Hospitals Have Higher Patient Care Costs due to Presence of Trainees - Treating Sicker Patients - Offering More Services, Tests & Technology • Calculated using Hospital-Specific Teaching Intensity (ratio of residents to beds), DRG Payments & Statutory IME Adjustment Factor for the Current Year

18. “New” Teaching Hospital • Hospital that starts Training Residents for the First Time on or after January 1, 1995 • Resident “Cap” is Set Based on the Number of Residents in All Specialty Programs in the 5th Year After Training Begins • Once Caps are Set, Urban Hospitals Generally Cannot Add Medicare-Funded Positions • Rural Hospitals Can Add New Specialties but Cannot Expand Existing Programs

19. FTE Cap • Hospital Can Train As Many Residents as it is Approved For • Medicare establishes a Limit (cap) on the Number of Residents It will Pay For • Cap Necessitates Advance Planning & a Strategic Approach to Developing a GME Program

20. OGME Development Initiative Marshalls the Resources of the AOA & the Osteopathic Profession to Help Hospitals Interested in Starting New Osteopathic GME Programs

21. OGME Development Initiative Employs – • A Strategic Approach • Expert Consultants • Useful Information on Starting and Operating High Quality OGME Programs

22. OGME Development Initiative Answers such Practical Questions as – • What are the Benefits of an OGME Program? • What Assistance & Information are Available? • How to Move Forward from Interest to Program Approval? • Where to Call for Complimentary In-Person Assistance from Experienced Consultants?

23. OGME Development Initiative Provides Support to Assist You in – • Adding an OGME Program to Your Hospital’s Strategic Plan • Reaping the Benefits of an OGME Program - To the Hospital - To Patients - To the Community - To the Medical Staff

24. Strategic Framework Helps You Determine How an OGME Program Fits with Your Hospital’s -

25. Strategic Framework • Mission: Why Does the Hospital Exist? - Patient Care & Physician Services? - Service to the Community? - Quality & Safety? - Education? - Research?

26. Strategic Framework • Vision: What Image does the Hospital Want to Portray as it Works to Accomplish its Mission?

27. Strategic Framework • Values: What Guiding Principles Drive the Hospital? - Moral Values? - Improving Community Health? - Providing Care for Those in Need? - Providing a Resource for Physicians?

28. SWOT Analysis A Strategic Framework Helps You - • Analyze How OGME Fits Into Your Hospital by Examining – - Internal Strengths - Internal Weaknesses - External Opportunities - External Threats

29. Knowledgeable Consultants Initiative Corps of Consultants includes • Seasoned Teaching Hospital CEOs & Senior Administrative Staff, Directors of Medical Education, Deans, Program Directors & Other Medical Educators

30. Knowledgeable Consultants Provide Peer-to-Peer Assistance, by Conference Call & On Site, to - • Answer Your Questions • Work One-on-One with Colleagues • Share their Expertise & Experience • Advise on Start-Up Costs & Medicare Payment • Guide You Through the Accreditation Process

31. Knowledgeable Consultants Help You Identify the Keys to Success – • Local Champions • Physician Leadership • Medical Staff • Hospital & System Administration • Hospital & System Boards • The Community • OPTIs

32. Knowledgeable Consultants Focus on Critical Components - • Faculty Resources • Community Needs • Adequate Medicare Percentage for Reasonable Payment • Sufficient Patient Load • Scope, Variety & Volume of Trainee Experiences

33. Information Provides You with Easy Access to Web-Based Resources on– • Medicare Funding • Program Approval & Accreditation • Educational Standards & Policies • Physician, Hospital & Trainee Agreements • Templates, Models & Forms Designed to Help You Start a High Quality Program