Case Studies

ARE WE LEVERAGING GME FOR MAXIMUM PRODUCTIVITY AND EDUCATIONAL VALUE?

THE CLIENT

An organization is currently operating over its CMS GME cap allotment, but leadership wishes to avoid closing any of its programs. They sponsor four programs that are a mix of residencies and fellowships.  All programs were successful in both recruitment, retention, graduate outcomes and were productive clinically in both the inpatient and ambulatory settings.

THE CHALLENGE

Effectively right size the client's GME footprint by reducing as many unfunded resident FTEs as possible without closing any of the programs or impacting key inpatient services that the programs support. Germane will be challenged with measuring resident training costs compared to the funding received by CMS. As leadership does not wish to close any programs, reducing resident FTEs will be crucial for the organization to utilize the whole of their CMS Cap.

THE SOLUTION

Through Germane’s GME Evaluation and Program Quality Assessments, Program Value, ACGME Compliance, and Operational Efficiency Analyses make crucial information more visible for the organization. For example, Program Value determined both the operational and strategic value of each sponsored GME program. ACGME Compliance gave clarity around the educational rationale of provided rotational experiences. The Operational Efficiency Analyses analytically reviewed how each GME program’s resident resources were being deployed throughout the health system at any given time. Once it was determined which GME programs would be affected by this possible reduction in resident resources, new resident rotation modeling was required to verify that resident staffing levels across key services would not be impacted and that residents would still be able to satisfy ACGME requirements prior to graduation. Lastly, the GME Economic Impact Assessment quantified the resulting economic impact to the organization due to the reduction of the resident FTE.

THE GERMANE EFFECT

The organization is saving $540,000 per year in perpetuity; creating a long-term sustainable GME Footprint, while all 4 GME programs remained open. The main primary care residency transferred to a new clinical training model that is predictive and well-leveraged to mitigate unintended consequences from reduction. The resident complement was reduced by five FTEs, allowing hospitals to run closer to their CMS Cap. All inpatient and ambulatory services remained fully staffed without work compression or work-life balance issues with all ACGME requirements remaining substantially satisfied.