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- Title
Medicare Support for Dental and Podiatry Graduate Medical Education Programs.
- Authors
Chen, Candice; Chung, YoonKyung; Broadbent, Geoffrey; Mertz, Elizabeth
- Abstract
This cross-sectional study investigates the amount of Medicare funding for dental and podiatry graduate medical education programs at teaching hospitals from 1998 to 2018. Key Points: Question: How much does the US invest in training the dental and podiatry workforce? Findings: In this cross-sectional study of US teaching hospitals, Medicare provided nearly $730 million in dental and podiatry graduate medical education (GME) payments to teaching hospitals in 2018, with per capita payments varying across states, territories, and the District of Columbia. Medicare payments for dental and podiatry GME increased from 1998 to 2018. Meaning: These findings suggest that dental and podiatry GME represents a substantial, growing public investment, and deliberate policy reform may be warranted to address national oral and podiatric health needs. Importance: Oral health care faces ongoing workforce challenges that affect patient access and outcomes. While the Medicare program provides an estimated $14.6 billion annually in graduate medical education (GME) payments to teaching hospitals, including explicit support for dental and podiatry programs, little is known about the level or distribution of this public investment in the oral health and podiatry workforce. Objective: To examine Medicare GME payments to teaching hospitals for dental and podiatry residents from 1998 to 2018, as well as the distribution of federal support among states, territories, and the District of Columbia. Design, Setting, and Participants: This cross-sectional study was conducted using data from 1252 US teaching hospitals. Data were analyzed from May through August 2020. Exposures: Dental and podiatry residency training. Main Outcomes and Measures: Medicare dental and podiatry GME payments were examined. Results: Among 1252 teaching hospitals, Medicare provided nearly $730 million in dental and podiatry GME payments in 2018. From 1998 to 2018, the number of residents supported more than doubled, increasing from 2340 residents to 4856 residents, for a 2.1-fold increase, while Medicare payments for dental and podiatry GME increased from $279 950 531 to $729 277 090, for a 2.6-fold increase. In 2018, an estimated 3504 of 4856 supported positions (72.2%) were dental. Medicare GME payments varied widely among states, territories, and the District of Columbia, with per capita payments by state, territory, and district population ranging from $0.05 in Puerto Rico to $14.24 in New York, while 6 states received no support for dental or podiatry residency programs. Conclusions and Relevance: These findings suggest that dental and podiatry GME represents a substantial public investment, and deliberate policy decisions are needed to target this nearly $730 million and growing investment to address the nation's priority oral and podiatry health needs.
- Subjects
WASHINGTON (D.C.); HEALTH policy; SOCIAL support; ACADEMIC medical centers; CROSS-sectional method; PODIATRY education; DENTAL education; INTERNSHIP programs; GRADUATE education; DESCRIPTIVE statistics; RESEARCH funding; DATA analysis software; MEDICAL education; MEDICARE
- Publication
JAMA Network Open, 2021, Vol 4, Issue 5, pe2111797
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2021.11797