HOW IS OUR GME FOOTPRINT IMPACTING OPERATIONAL GOALS?

HOW IS OUR GME FOOTPRINT IMPACTING OPERATIONAL GOALS?

THE CLIENT

Germane was contacted by a health system consisting of 4 hospitals. Within this health system, their flagship hospital contained legacy residency and fellowship programs through an affiliation with a local medical school, one hospital had previous cap issues, and the other two were non-teaching hospitals. Health System leadership was interested in learning how to optimize the current resident operations at their flagship teaching hospital and work to grow the GME footprint in their non-teaching hospitals to meet their organizational goals.

THE CHALLENGE

To better understand their current operations and future opportunities, an in-depth review of the hospitals’ current programs is needed to propose recommendations and direction. This review will be comprehensive; encompassing recommendations to optimize current GME operations, investigate prior CMS cap issues, explore future GME offerings. Germane will also inspect the hospital’s affiliated partner.

THE SOLUTION

These challenges are solved by several interrelated assessments that Germane conducts. A GME program value review investigates any existing GME programs. An Academic Affiliation Review is focused on the relationship between the hospital and its affiliation evaluating the benefit to both parties. Medicare Cost Report Review will identify GME reporting and payment errors. A New Program Initial Feasibility Assessment will provide information to the hospital leadership outlining which programs could potentially be supported within the hospital.

THE OUTCOME

Through the Medicare cost report, Germane reversed CMS interpretation of limiting GME development at the “capped” hospital and found corrections worth 2 million dollars related to GME payment errors. The GME program value review provided recommendations outlining several of the existing programs which offered limited value to the system. Per the Academic Affiliation Review, the hospital received improved benefits from their affiliation, such as improved information sharing and change in resident complements. Germane, also, identified new residency programs supporting 150 new students between the three non-teaching hospitals with a positive margin of operations by 1.5 million dollars factoring state, federal, and grant GME reimbursement.

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