RENO, NV – Today, U.S. Senator Jacky Rosen (D-NV), a member of the Senate Committee on Health, Education, Labor and Pensions (HELP), held a roundtable discussion with representatives from state medical schools and hospitals focused on physician provider shortages and how to better support Nevada’s graduate medical education (GME) programs and medical schools, and identify ways to improve the system to reduce provider shortages in the state and across the country. The roundtable discussion follows the recent issuance of a Government Accountability Office (GAO) report requested by Senator Rosen, which examined GME programs and medical provider shortages in the U.S.
“The medical provider shortage in Nevada and across our nation has left countless communities without proper access to care,” said Senator Rosen. “I was glad to meet with Nevada’s medical education professionals to discuss the impact that provider shortages have on care in our state and to develop forward-thinking solutions that will improve access. I will continue to work alongside Nevada’s medical community to ensure that Nevadans have the proper care that they deserve.”
“Through increased investment in our state’s medical residency programs, we can provide greater access to care in our communities,” said Melissa Piasecki, M.D., Executive Associate Dean, University of Nevada, Reno School of Medicine. “The work Senator Rosen is doing to enhance our medical system will lead to more medical professionals in our state, benefitting Nevadans and improving their ability to seek care.”
BACKGROUND: Senator Rosen is a co-sponsor of the Rural Physician Workforce Production Act. This legislation would lift the current caps on Medicare GME payments to rural hospitals. This would help eliminate the disadvantage that rural hospitals face when recruiting new medical professionals. The bill also would allow Medicare to reimburse urban hospitals that send residents to train at rural health care facilities during a resident rotation, and it would establish a per-resident payment initiative to ensure rural hospitals have the resources to bring on additional residents.
Senator Rosen is also a co-sponsor of the Resident Physician Shortage Reduction Act which would increase GME slots by 2,000 per year. Current law provides for an increase of up to 200 positions per fiscal year beginning in FY2023, with a total increase of 1,000 positions (up to 25 per hospital). This bill provides for an additional increase of 2,000 positions per fiscal year from FY2023-FY2029; during this period, each hospital may receive up to 75 additional positions in total under the bill and current law.
In 2019, Senator Rosen sent a letter to GAO requesting a report on GME and physician shortages. GAO completed the report this summer. Some of the report’s key findings include:
- 70% of hospitals train more residents than Medicare funds, indicating a training capacity greater than current caps.
- 20% of hospitals train below at least one of their caps, and 11% were under both.
- This equates to 2% of Medicare-eligible cap slots going unfilled, which is 1400-1500 slots (depending on Direct or Indirect GME funding).
- Hospitals under their caps are generally smaller and in rural areas.
- Hospitals may reallocate slots to other hospitals, and GAO found that around 40 percent of hospitals have used this option.