Sec. 312. Findings; sense of Congress relating to graduate medical education
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Congress finds the following: Projections by the Association of American Medical Colleges
(AAMC)and other expert entities, such as the Health Resources and Services Administration (HRSA), have indicated a nationwide shortage of up to 104,900 physicians, split evenly between primary care and specialists, by 2030. Primarily due to the growing and aging population, over the next decade, physician demand is expected to grow up to 17 percent. The United States Census Bureau estimates that the United States population will grow from 321 million in 2015 to 347 million in 2025. Further, the number of Medicare beneficiaries is estimated to increase from 47.8 million in 2015 to approximately 66 million in 2025. Approximately 36 percent of practicing physicians are over the age of 55 and are likely to retire within the next decade. A nationwide physician shortage will result in many Americans waiting longer and traveling farther for health care; seeking nonemergent care in emergency departments; and delaying treatment until their health care needs become more serious, complex, and costly. Changing demographics (such as an aging population), new health care delivery models (such as medical homes), and other factors (such as disaster preparedness) are contributing to a shortage of both generalist and specialist physicians. These shortages will have the most severe impact on vulnerable and underserved populations, including racial/ethnic minorities and the approximately 20 percent of Americans who live in rural or inner-city locations designated as health professional shortage areas. The AAMC’s Health Care Utilization Equity model estimates that if racial and ethnic minorities and individuals from rural areas utilized health care in a similar way to their Caucasian counterparts living in metropolitan areas, the physician shortage would require an additional 96,000 physicians. To address the physician shortage, medical education and training need to be accessible for students and physicians from all backgrounds. International graduates play an important role in U.S. health care, representing roughly 25 percent of the health care workforce. Immigration pathways like student, exchange-visitor, and employment visas, and programs like the National Interest Waiver and Conrad 30 J–1 Visa Waiver, help improve health access across the country. United States medical schools have committed to and have initiated a 30 percent increase in enrollment by 2017 to help reduce the Nation’s shortage of quality physicians. An increase in United States medical school graduates must be accompanied by an increase of 4,000 graduate medical education
(GME)training positions each year. Graduate medical education programs and teaching hospitals provide venues in which the next generation of physicians learns to work collaboratively with other physicians and health professionals, adopt more efficient care delivery models (such as care coordination and medical homes), incorporate health information technology and electronic health records in every aspect of their work, apply new methods of assuring quality and safety, and participate in groundbreaking clinical and public health research. The Medicare Program under title XVIII of the Social Security Act (having more beneficiaries than any other health care program), supports its fair share of the costs associated with graduate medical education (GME). In general, the level of support of graduate medical education by the Medicare Program has been capped since 1997 and has not been increased to support the expansion of graduate medical education programs needed to avert the projected physician shortage or to accommodate the increase in United States medical school graduates. It is the sense of Congress that eliminating the limit of the number of residency positions that receive some level of Medicare support under section 1886(h) of the Social Security Act ( 42 U.S.C. 1395ww(h) ), also referred to as the Medical graduate medical education cap, is critical to— ensuring an appropriate supply of physicians to meet the Nation’s health care needs; facilitating equitable access for all who seek health care; and mitigating disparities in health and health care.
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Sec. 312
Findings; sense of Congress relating to graduate medical education
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