Finance
Our services encompass several key areas, through which our finance experts provide financial insights related to Graduate Medical Education for varying healthcare organizations. We help you understand regulations that govern Medicare GME Reimbursement and provide insights on the associated costs the Accreditation Council for Graduate Medical Education (ACGME) requires all teaching hospitals to maintain. Germane Solutions is here to serve as your trusted advisor and guide you through all phases of the GME life cycle.
GME Finance Models and Proforma Development
Every client is different, which is why we take a tailored approach when developing and outlining the available financial opportunities to make your GME vision a reality. Using our industry insights and our team of GME finance experts, we create the financial blueprint that provides the necessary funding to sustain your short-term and long-term vision.
At-Risk/ CMS Cost Report Review
The rules that govern Medicare GME Reimbursement are complex and change frequently throughout the growth and development of residency training. As a result, we often see hospitals fail to fully acquire valuable reimbursement. While this can have short-term implications, primarily affecting your hospital's cash flow, it can be extremely detrimental to your long-term budget once permanent caps are established. We partner with your Reimbursement team to review Medicare Cost Reports (MCRs) and ensure all claims for GME reimbursement are accurate while minimizing audit risks.
Rural Designation
With the yearly updates to the IPPS rules, a Rural Designation Strategy can be a viable opportunity for previously capped hospitals to create new GME funding while minimizing the impact of the reduced wage index. We work with you to determine the feasibility of changing provider designation from Urban to Rural and outline the short, and long-term financial implications. This strategy typically yields an annual benefit to our clients of $7.9M with a net benefit over 10 years of $58M.
GME Profiles and Business Cases
With any strategic decision, understanding the business case of GME is imperative for long-term success. We partner with you to provide the necessary education 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 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 provide the academic and financial rationale to execute this agreement within single health systems or between multiple academic medical centers with the goal of maximizing the resources available for medical education.
Revenue Modeling
We work to provide in-depth knowledge and insights related to clinical revenues generated by residents and fellows in outpatient settings. This revenue has historically been categorized incorrectly and is difficult to quantify as a benefit that GME provides to the system. Our experts will be able to assist in uncovering the benefits provided by residency and fellowship programs that have historically gone unrecognized by organizations across the country.
Your Finance Partner
Scott Masin, MBA
Scott delivers financial and strategic expertise utilizing methods that incorporate Medicare Cost Reports and Medicare GME Reimbursement. He has significant experience in GME systems strategy, feasibility assessments, system affiliations, and resident schedules that allow for maximum reimbursement for hospitals. Scott holds a Bachelor of Science from Wittenberg University and a Master of Business Administration from Wright State University.
