Cargando…

An Old Idea is a Novel Concept for Supplemental Funding of Surgical Residency Programs

Background In July 2014, the Institute of Medicine released a review of the governance of Graduate Medical Education (GME), concluding that changes to GME financing were needed to reward desired performance and to reshape the workforce to meet the nation’s needs. In light of the rapid emergence of a...

Descripción completa

Detalles Bibliográficos
Autores principales: Dimon, Matthew, Ahmed, Bestoun, Pieper, Pam, Burns, Bracken, Tepas, Joseph J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086109/
https://www.ncbi.nlm.nih.gov/pubmed/32219047
http://dx.doi.org/10.7759/cureus.7053
_version_ 1783509064684142592
author Dimon, Matthew
Ahmed, Bestoun
Pieper, Pam
Burns, Bracken
Tepas, Joseph J
author_facet Dimon, Matthew
Ahmed, Bestoun
Pieper, Pam
Burns, Bracken
Tepas, Joseph J
author_sort Dimon, Matthew
collection PubMed
description Background In July 2014, the Institute of Medicine released a review of the governance of Graduate Medical Education (GME), concluding that changes to GME financing were needed to reward desired performance and to reshape the workforce to meet the nation’s needs. In light of the rapid emergence of alternative payment systems, we evaluated the financial value of resident participation in operative surgical care.  Methods The Department of Surgery provided Current Procedural Terminology (CPT) codes for procedures performed by the general surgical service at our institution for the 2011 academic year. For each code, the charge and total instances were provided. CPTs allowing an assistant fee were identified using the Searchable Medicare Physician Fee Schedule. This approach enabled calculation of the potential resident contribution to GME funding. Results A total of 515 unique CPTs were potentially billable for a total of 6,578 procedures, of which 2,552 (39%) were reimbursable. These CPTs would have generated $1,882,854 in assistant charges. The top 50 most frequent CPTs resulted in 4,247 procedures. Within the top 50, 1362 procedures (32% of the top 50, 21% of the total) were reimbursable. Of the total assistant charges, $963,227 (51%) occurred in the top 50 most frequent CPTs. Conclusions Credit for resident participation in operative care as co-surgeon would average $67,244 per resident, compared to our current funding of $142,635 per resident. This type of alternative funding could provide 47% of current educational support. The skew in distribution of procedures also suggests that such a system could provide guidance to a more balanced operative experience. Such performance-based credentialing could be used to ensure appropriate housestaff for a given case; these reimbursements could also be adjusted based on quality metrics to provide for transformational change in patient outcomes.
format Online
Article
Text
id pubmed-7086109
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-70861092020-03-26 An Old Idea is a Novel Concept for Supplemental Funding of Surgical Residency Programs Dimon, Matthew Ahmed, Bestoun Pieper, Pam Burns, Bracken Tepas, Joseph J Cureus General Surgery Background In July 2014, the Institute of Medicine released a review of the governance of Graduate Medical Education (GME), concluding that changes to GME financing were needed to reward desired performance and to reshape the workforce to meet the nation’s needs. In light of the rapid emergence of alternative payment systems, we evaluated the financial value of resident participation in operative surgical care.  Methods The Department of Surgery provided Current Procedural Terminology (CPT) codes for procedures performed by the general surgical service at our institution for the 2011 academic year. For each code, the charge and total instances were provided. CPTs allowing an assistant fee were identified using the Searchable Medicare Physician Fee Schedule. This approach enabled calculation of the potential resident contribution to GME funding. Results A total of 515 unique CPTs were potentially billable for a total of 6,578 procedures, of which 2,552 (39%) were reimbursable. These CPTs would have generated $1,882,854 in assistant charges. The top 50 most frequent CPTs resulted in 4,247 procedures. Within the top 50, 1362 procedures (32% of the top 50, 21% of the total) were reimbursable. Of the total assistant charges, $963,227 (51%) occurred in the top 50 most frequent CPTs. Conclusions Credit for resident participation in operative care as co-surgeon would average $67,244 per resident, compared to our current funding of $142,635 per resident. This type of alternative funding could provide 47% of current educational support. The skew in distribution of procedures also suggests that such a system could provide guidance to a more balanced operative experience. Such performance-based credentialing could be used to ensure appropriate housestaff for a given case; these reimbursements could also be adjusted based on quality metrics to provide for transformational change in patient outcomes. Cureus 2020-02-20 /pmc/articles/PMC7086109/ /pubmed/32219047 http://dx.doi.org/10.7759/cureus.7053 Text en Copyright © 2020, Dimon et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle General Surgery
Dimon, Matthew
Ahmed, Bestoun
Pieper, Pam
Burns, Bracken
Tepas, Joseph J
An Old Idea is a Novel Concept for Supplemental Funding of Surgical Residency Programs
title An Old Idea is a Novel Concept for Supplemental Funding of Surgical Residency Programs
title_full An Old Idea is a Novel Concept for Supplemental Funding of Surgical Residency Programs
title_fullStr An Old Idea is a Novel Concept for Supplemental Funding of Surgical Residency Programs
title_full_unstemmed An Old Idea is a Novel Concept for Supplemental Funding of Surgical Residency Programs
title_short An Old Idea is a Novel Concept for Supplemental Funding of Surgical Residency Programs
title_sort old idea is a novel concept for supplemental funding of surgical residency programs
topic General Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086109/
https://www.ncbi.nlm.nih.gov/pubmed/32219047
http://dx.doi.org/10.7759/cureus.7053
work_keys_str_mv AT dimonmatthew anoldideaisanovelconceptforsupplementalfundingofsurgicalresidencyprograms
AT ahmedbestoun anoldideaisanovelconceptforsupplementalfundingofsurgicalresidencyprograms
AT pieperpam anoldideaisanovelconceptforsupplementalfundingofsurgicalresidencyprograms
AT burnsbracken anoldideaisanovelconceptforsupplementalfundingofsurgicalresidencyprograms
AT tepasjosephj anoldideaisanovelconceptforsupplementalfundingofsurgicalresidencyprograms
AT dimonmatthew oldideaisanovelconceptforsupplementalfundingofsurgicalresidencyprograms
AT ahmedbestoun oldideaisanovelconceptforsupplementalfundingofsurgicalresidencyprograms
AT pieperpam oldideaisanovelconceptforsupplementalfundingofsurgicalresidencyprograms
AT burnsbracken oldideaisanovelconceptforsupplementalfundingofsurgicalresidencyprograms
AT tepasjosephj oldideaisanovelconceptforsupplementalfundingofsurgicalresidencyprograms