Treatment of the initial residency period in Medicare’s direct graduate medical education payments

The Congress should eliminate the weighting factors that currently determine Medicare’s direct graduate medical education payments and count all residencies equally through completion of residents’ first specialty or combined program and subspecialty if one is pursued. Residents training longer than the minimum number of years required for board eligibility in a specialty, combined program, or subspecialty should not be included in hospitals’ direct graduate medical education resident counts. These policy changes should be implemented in a budget-neutral manner through adjustments to the per resident payment amounts.