Sustaining Teaching Hospitals and the Services They Provide: DGME, IME, and DSH

Bringing Together Patient Care, Research, and Education

The Issue

A teaching hospital refers to individual hospitals, health systems, and networks that deliver state-of-the-art care for all, including the most vulnerable patients with the most complex conditions, and are committed to educational activities in the health professions. Most of the largest teaching hospitals are affiliated with medical schools. Additionally, Department of Veterans Affairs medical centers are also teaching hospitals.

Only at teaching hospitals do the three missions of medical education, research, and care come together for the benefit of all patients. In this unique environment, the next generation of doctors, nurses and other health professionals are trained in an environment of discovery and the latest advances in medicine. In teaching hospitals and their affiliated clinical sites, new doctors learn the skills that they’ll use throughout their careers, no matter where they practice. Teaching hospitals also are distinguished by their clinical research programs where scientists and physicians work together to discover and bring new treatments and cures from the bench to the bedside safely and quickly.

Teaching hospitals rely on Medicare direct graduate medical education (DGME) and indirect medical education (IME) payments to support the training of new physicians to meet the increasing requirements of an aging population. These payments also help cover the additional patient care costs incurred by teaching hospitals for the services they provide and the patient populations they treat.

The Solution

Teaching hospitals will continue their mission-driven roles to provide care for all patients, including the most complex and vulnerable; train the next generation of healthcare professionals; and conduct research to discover new treatments and cures.

To sustain our nation’s teaching hospitals and the irreplaceable services they provide, the AAMC urges that Congress maintain the DGME payment and IME adjustment at their current levels and adequately increase Medicare Disproportionate Share Hospital (DSH) payments to ensure appropriate reimbursement for teaching hospitals as they continue to see an increase in the disproportionate number of uninsured and underinsured patients they care for.

Resources

Roles of Teaching Hospitals

Teaching Hospitals and Patient Care

Teaching Hospitals and Graduate Medical Education

Medicare Mission Payments to Teaching Hospitals

Other Resources