Explore our Finance service line and what Germane can offer to your organization.

Germane Solutions' Finance service line focuses on providing financial insights related to Graduate Medical Education for healthcare organizations of all shapes and sizes. Germane can help you understand the regulations that govern Medicare GME Reimbursement and the associated costs that the Accreditation Counsel for Graduate Medical Education (ACGME) requires all teaching hospitals to maintain. We partner with our clients to guide them through all phases of the GME life cycle.

GME Financial Models & Proforma Development

We take a tailored approach to each client’s vision for GME development and outline all the available financial opportunities to make that vision a reality. Using our industry insight and team of subject matter experts, we can create the financial blueprint that will provide the long-term funding necessary to sustain medical education now and into the future.

At-Risk/CMS Cost Report Review

The rules that govern Medicare GME Reimbursement are complex and change throughout the growth and development of residency training. As a result, we often see hospitals leave valuable reimbursement on the table. While this can have an immediate impact on cash-flow, it can be very detrimental when permanent caps are established. We partner with your Reimbursement team to review Medicare Cost Reports (MCRs) to ensure all claims for GME reimbursement are accurate while minimizing audit risks.

Rural Designation

With the recent updates to the 2023 IPPS rules, a Rural Designation Strategy can be an opportunity for previously capped hospitals to create new GME funding while minimizing the impact of the reduced wage index. We will work with you to determine the feasibility of changing provider designation from Urban to Rural and outline the short, and long-term financial implications.

GME Profiles & Business Cases

With any strategic decision, understanding the business case of GME is the first step to long-term success. We partner with your team to provide the education necessary to feel confident about undertaking a new initiative and training the next generation of doctors. We review the financial considerations of building new GME programs including state and federal funding mechanisms, altering the size or mix of programs, and redistributing GME programs across various landscapes to provide the resources necessary for sustainability. Our work across the country has provided us with significant experience with programs in traditional and non-traditional settings, such as Federally Qualified Health Centers (FQHCs), private offices, academic medical centers with multiple hospital partners, and national healthcare systems with operations in various states.

Medicare GME Affiliation Agreement

Medicare GME Affiliation Agreements allow hospitals to temporarily transfer IME and DGME cap from one MCR to another. This ensures the financial resources follow the residents during their course of training. Since most community hospitals don’t have all the academic experiences necessary to meet ACGME requirements, this agreement provides the opportunity to expand the training to multiple provider and non-provider locations. We can provide the academic and financial rationale to execute this type of agreement within single health systems or between multiple academic medical centers with the goal of maximizing the resources available for medical education.

These case studies provide insight into how we put these offerings together to create value for you.

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