$1.3 trillion federal appropriations bill loaded with new health care spending Last Friday, President Trump signed a massive $1.3 trillion federal spending bill—the Omnibus Consolidated Appropriations Act of 2018. It is loaded with new spending for health care programs that were supported by the California Medical Association (CMA). Unfortunately, it did not include two bills that CMA was strongly promoting – the Affordable Care Act (ACA) market stabilization bill and a permanent solution for the nearly 700,000 Deferred Action for Childhood Arrivals program recipients. A brief summary of the federal spending bill is below. Bipartisan ACA Market Stabilization: CMA, the American Medical Association (AMA) and other physician groups strongly advocated to include the bipartisan ACA market stabilization bill in the omnibus spending package. Unfortunately, lawmakers could not reach a compromise. It would have funded for two-years the cost-sharing assistance that helps low-income families afford copayments and deductibles that President Trump eliminated in 2017. It would have also provided state waiver flexibility and reinsurance funding to cover high-cost, catastrophic cases. The Congressional Budget Office estimated that the bill would have reduced premiums by 20 percent in 2020. A compromise could not be reached because the Freedom Caucus insisted on placing abortion restrictions on the ACA plans in exchange for the two-year ACA stabilization bill. Opioids: The bill includes nearly $4 billion in new funding for prevention, treatment and law enforcement to address the opioid crisis. With the $6 billion in the Budget Act enacted by Congress in February, new 2018-2019 opioid funding totals $10 billion. The breakdown is as follows: $500 million for National Institutes of Health research on opioid addiction, development of opioid alternatives, pain management and addiction treatment. $27 million for Mental and Behavioral Health Education Training to recruit and train professionals in psychiatry, psychology, social work, marriage and family therapy, substance abuse prevention and treatment, and other areas. $105 million for the National Health Service Corps to expand access to opioid and substance use disorder treatment in rural and underserved areas. $100 million for a new Rural Communities Opioids Response Program to support prevention and treatment of substance use disorder in 220 counties and other rural communities identified by the Centers for Disease Control and Prevention (CDC) as being at high risk. $350 million (for a total of $475 million) to support CDC’s Opioid Prescription Drug Overdose Prevention activities. $10 million must be used to conduct a nationwide opioid education campaign to increase understanding of the epidemic and to increase prevention activities. Also requires CDC to promote the use of prescription drug monitoring programs (PDMP) and expand efforts to enhance the utility of state PDMPs to make them more interconnected, in real-time, and usable for public health surveillance and clinical decision making. CMA aggressively advocated for this provision to ensure that the federal government work with electronic health record (EHR) vendors to link EHRs to state PDMPs. $1 billion in new funding for State Opioid Response Grants $94 million for law enforcement and grants to combat opioid, heroin and other drug trafficking. $94 million to strengthen Food and Drug Administration (FDA) presence at international mail facilities and to fund equipment and technology to increase FDA capacity to inspect more incoming packages to detect illicit fentanyl. Gun Violence: The bill included $2.3 billion in funding associated with the STOP School Violence Act of 2018 to cover mental health services, security training and school safety programs to prevent gun violence. It also fully funds the FBI National Instant Criminal Background Check System. While CDC research promoting gun control is still prohibited, the Omnibus spending bill included a general clarification that there are no restrictions on general research related to gun violence. However, there was no funding appropriated for such research. Finally, it increased funding for the National Violent Death Reporting System to all 50 states to assist researchers and lawmakers. CMA continues to support California Senator Dianne Feinstein’s legislation that would ban assault weapons and high-capacity magazines, as well as efforts to require more extensive background checks and waiting periods. Mental Health Programs: Provides more than $2.3 billion in new funding for various mental health programs. Drug-Related Provisions: Physicians will continue to receive enhanced payments for the first few years a drug/biological is on the market to assist in the costs of adopting new drugs and technology. Graduate Medical Education: The Children’s Hospitals graduate medical education program received a $15 million funding increase, for a total of $315 million. Congress also provided an additional $15 million for the Rural Residency Program to expand the number of rural residency training programs with a focus on developing programs that can be self-sustainable. Other Notable Health Care Spending Increases: The National Institutes of Health received significant increase in funding to support research into Alzheimer’s disease, the Brain Initiative, the universal flu vaccine and antibiotic-resistance efforts. The CDC also received additional funding for diabetes programs. April 5, 2018 General Affordable Care Act, Drug Abuse, Federal Budget, Federal Legislative Advocacy, Firearms, Graduate Medical Education, Guns, Mental Health, Opioids 0 0 Comment Read More »
State awards $30.5 million in primary care residency program funding The California Healthcare Workforce Policy Commission awarded upwards of $30.5 million to support more than 175 primary care residency slots for the 2017 cycle of the Song Brown Healthcare Workforce Training Program. A record number of applications were received this year, in large part due to the additional physician workforce funding secured by the California Medical Association (CMA) through the state budget. In 2016, the California legislature passed a budget that committed $100 million over three years ($33 million each year) in health care workforce funding. Although Governor Brown proposed to eliminate these funds in his 2017-2018 budget, CMA fought to maintain this important funding, which is critical as we work to address California’s primary care physician shortage. Song Brown funding is available for existing primary care residency slots, existing Teaching Health Center slots, expansion slots within existing programs, and new primary care programs that will obtain accreditation within a year of the contract period. A robust and well-trained primary care workforce is essential to meeting the health care demands of all Californians. Training more physicians to meet the growing demands of an aging population with multiple chronic conditions remains one of CMA’s top priorities. California is experiencing a severe shortage of primary care physicians, particularly in the rural and Central Valley regions of the state. Our state has one of the lowest primary care physician to patient ratios in the nation. Some estimates show that California will need an additional 8,243 primary care physicians by 2030 – a 32 percent increase. Data shows that most physicians set down roots in the areas where they train and remain there after their training to care for their communities. Inadequate funding for residency programs exacerbates access problems—every year, hundreds of graduating medical students don't find a residency slot in California to continue their training, forcing talented young doctors who want to stay and practice in California to other states and communities. Click here to view a complete list of 2017 Song Brown awardees. February 5, 2018 CMA, General GME, Graduate Medical Education, Physician Workforce, Primary Care, Residents and Fellows, Song Brown Healthcare Workforce Training Program 0 0 Comment Read More »
State sees marked increase in applications for primary care residency program funding The California Office of Statewide Health Planning and Development received a record number of applications for family medicine and primary care residency funding through the Song Brown Healthcare Workforce Training Program. For the 2017 application cycle, 77 applications were received, representing 103 residency slots. The increase is due in part to additional physician workforce funding secured by the California Medical Association (CMA) through the state budget. In 2016, the California legislature passed a budget that committed $100 million over three years ($33 million each year) in health care workforce funding. Although Governor Brown proposed to eliminate these funds in his 2017-2018 budget, CMA fought to maintain this important funding, which is critical as we work to address California’s primary care physician shortage. This funding is available for existing primary care residency slots, existing Teaching Health Center slots, expansion slots within existing programs, and new primary care programs that will obtain accreditation within a year of the contract period. The 77 applications received for primary care residency funding include: 48 family medicine residency programs (including 10 expansion slots and eight new programs) 14 internal medicine residency programs (including three expansion slots) 6 OB-GYN residency programs (including two new programs) 9 pediatric residency programs (including one expansion slot) A robust and well-trained primary care workforce is essential to meeting the health care demands of all Californians. Training more physicians to meet the growing demands of an aging population with multiple chronic conditions remains one of CMA’s top priorities. California is experiencing a severe shortage of primary care physicians, particularly in the rural and Central Valley regions of the state. Our state has one of the lowest primary care physician to patient ratios in the nation. Some estimates show that California will need an additional 8,243 primary care physicians by 2030 – a 32 percent increase. Data shows that most physicians set down roots in the areas where they train and remain there after their training to care for their communities. Inadequate funding for residency programs exacerbates access problems—every year, hundreds of graduating medical students don't find a residency slot in California to continue their training, forcing talented young doctors who want to stay and practice in California to other states and communities November 14, 2017 CMA, General Graduate Medical Education, Physician Workforce, Residents and Fellows 0 0 Comment Read More »
California congressmen introduce bills to address physician shortage Two important bills have been introduced in Congress to address our state’s serious physician shortage and improve access to care in California. The first bill, the Training the Next Generation of Primary Care Doctors Act of 2017 (HR 3394), would reauthorize for an additional three years the Teaching Health Center Graduate Medical Education (GME) program that was established by the Affordable Care Act (ACA). The Teaching Health Center program is a community-based primary care physician training program that has been extremely successful in expanding the physician workforce in underserved areas. This bill would also expand the number of residency positions available within existing teaching health centers and establish sustainable funding. This bill has bipartisan cosponsorship by California Congressmen Raul Ruiz, M.D. (D-Palm Springs), Jeff Denham (R-Modesto) and David Valadao (R-Fresno). The second bill, the Comprehensive Additional Residency Expansion Act (HR 3451), introduced by Congressman Jeff Denham (R-Modesto) and sponsored by the California Medical Association (CMA), would build on HR 3394. The Teaching Health Center GME program currently supports 742 residents at 59 teaching health centers. This bill would add an additional 240 residency slots to train new physicians and authorize 10 new teaching health centers. It would also require the new teaching health centers be located in areas with a disproportionate share of Medicaid patients to help alleviate physician shortages and access to care in underserved regions. These bills are critically important because California is experiencing a severe shortage of primary care physicians, particularly in the rural and Central Valley regions of the state. Our state has one of the lowest primary care physician to patient ratios in the nation. Only 10 percent of physicians practice in rural areas nationwide, although 25 percent of the population resides in these regions. Training more physicians to meet the growing demands of an aging population with multiple chronic conditions is a CMA priority. We support efforts to encourage more physicians to practice in underserved areas to improve access to care. The underserved Central Valley region of California in particular has experienced difficulty attracting and retaining physicians. Data shows that most physicians set down roots in the areas where they train and remain there after their training to care for their communities. These two bills will help to create a new generation of rural physicians and ensure that patients in those areas have access to essential preventive and primary care to diagnose and treat health problems early. These are important bills that represent a practical approach to improving the physician shortage crisis and access to care challenges in California’s underserved areas. August 9, 2017 General Federal Legislation, Federal Legislative Advocacy , Graduate Medical Education, Physician Workforce, Primary Care, Rural Health, Underserved Communities 0 0 Comment Read More »
California grapples with 'severe' doctor shortage, study shows California doesn't have enough doctors to handle its primary health care demands and the problem is getting worse. A new study by UCSF Healthforce Center finds that California doesn’t have enough primary care physicians in most regions of the state. According to the study, the shortage is becoming more acute because of an aging physician workforce, a growing patient population and expanded coverage through the Affordable Care Act. According to the study, only two regions of California (the Greater Bay Area and Sacramento) have ratios of primary care physicians per population above the minimum ratio recommended by the Council on Graduate Medical Education (60 primary care physicians per 100,000 people). The study also found that two regions (the Inland Empire and San Joaquin Valley) have ratios of primary care physicians to population that are below the minimum required by California law for managed care plans (50 primary care physicians per 100,000 people). Some estimates show that California will need an additional 8,243 primary care physicians by 2030 – a 32 percent increase. In an effort to increase California's primary care physician workforce, the state legislature passed a budget in 2016 that included historic support for and expansion of primary care graduate medical education (GME)—committing to invest $100 million over three years to support primary care residency programs in medically underserved areas. Unfortunately, Governor Jerry Brown’s proposed 2017 budget takes a huge step backward, eliminating $33.4 million of that health care workforce funding and redirecting $50 million in Prop. 56 funding that was intended to go to GME programs. The California Medical Association (CMA) believes these budget cuts are irresponsible and make a bad situation worse. A robust and well-trained primary care workforce is essential to meeting the health care demands of all Californians. Inadequate funding for residency programs exacerbates access problems—every year hundreds of graduating medical students don't find a residency slot in California to continue their training, forcing talented, young doctors who want to stay and practice in California to other states and communities. CMA will be working through the budget negotiation process to restore this critical funding. We are also urging physicians, residents and medical students to ask their legislators to oppose Governor Brown’s budget proposal to eliminate physician workforce funding. For more information on the budget as it relates to health care, including GME funding talking points, see CMA's budget summary. Click here to read the UCSF study. March 2, 2017 General California State Budget, Graduate Medical Education, Physician Workforce, Primary Care, State Legislative Advocacy, Underserved Communities 0 0 Comment Read More »
AMA and CMA efforts to secure adequate funding for GME continue In an effort to increase the number of medical residency slots and to help address the national physician shortage, delegates to the American Medical Association (AMA) renewed their support for alternative funding sources for graduate medical education (GME). AMA also adopted policy to explore additional funding models for GME beyond those examined in the Institute of Medicine’s 2014 report on GME governance and financing. Under the new policy, AMA will encourage insurance payors and foundations to enter into partnerships with state and local agencies, as well as academic medical centers and community hospitals, to expand GME funding. The policy also calls on organizations with successful GME funding models to share strategies, outcomes and implementation costs. Additionally, AMA plans to increase public awareness of the importance of graduate medical education, student debt and the state of the medical profession. “We are committed to expanding funding for GME to ensure that there are enough residency slots to train physicians in regions where health care services are needed most,” said AMA Board Member Jesse M. Ehrenfeld, M.D. “This means urging all health care payers at local, state and federal levels as well as private entities to work together to adequately fund GME programs with the goal of reducing physician shortages and increasing patient access to the care they need.” The United States is facing a severe shortage of doctors, which is expected to get exponentially worse as the population continues to grow and our aging physician workforce moves toward retirement. It is projected that by 2025 we will have up to 90,000 fewer physicians than the country needs. While advances in technology and workflow will certainly make physicians more efficient over time, the need for more doctors is still larger than ever to take on the current challenges in the health care system. GME is the hands-on training phase of physician education that is mandatory in order for physicians to obtain licenses for independent practice. During this clinical training, residents also provide needed care for one out of every five hospitalized patients, including our seniors, veterans and patients in underserved communities. With a growing demand for health care services, cuts to federal funding for physician residency programs will only worsen physician shortages across the country. Workforce experts predict a physician shortage of 62,900 as soon as 2015, which will increase to 130,000 by 2025.This shortage increases demand on our health care delivery system as more seniors begin to join the Medicare program and newly insured Americans seek access to care. Although federal, state and private funds pay for GME, federal contributions through Medicare make up the bulk of the funding, about $9.5 billion annually nationwide. This figure hasn’t changed in nearly 20 years. Inadequate funding for residency programs means that last year, 440 U.S. seniors in M.D. programs did not find a residency spot – and that needs to change! AMA and the California Medical Association are supporting two legislative initiatives: the Resident Physician Shortage Reduction Act of 2015 (H.R. 2124/S. 1148) and the Creating Access to Residency Education Act of 2015 (H.R. 1117). AMA is seeking additional champions in Congress as well as innovative solutions to help advance this critical issue, which will dramatically affect access to health care for the entire country. For more information and details on how you can get involved, including sample letters, tweets and talking points, visit www.savegme.org. December 7, 2015 General Graduate Medical Education, Physician Workforce, GME, Physician Supply 0 0 Comment Read More »
CMA takes on public health, Medi-Cal with 2015 sponsored legislation California Medical Association (CMA) sponsored bills for 2015 include a $2 per pack tax on cigarettes, increasing provider rates for Medi-Cal and establishing a Graduate Medical Education Trust Fund in light of inadequate funding levels from the federal government. SB 591 (Pan) – Cigarette and tobacco products taxes: California Tobacco Tax Act of 2015 This bill is the CMA-led Save Lives Coalition’s legislative strategy to increase the state’s tobacco tax by $2 per pack. The bill would allocate funds raised by the tax to tobacco prevention and education, programs provided by the California Department of Health Care Services (DHCS) and enforcement of tobacco laws. The Los Angeles Times recently editorialized in favor of SB 591. AB 1396 (Bonta) – Tobacco Tax Funding Implementation Medi-Cal The bill would provide oversight for allocation of the funds raised by the SB 591 (Pan) tobacco tax that are slated for use by DHCS for Medi-Cal. It would require that DHCS meet the federal government mandate that Medi-Cal payments are consistent with certain standards and are sufficient to enlist enough providers to serve eligible populations. It would also require an annual independent assessment of whether Medi-Cal provider rates achieve those standards. SB 243 (Hernandez) and AB 366 (Bonta) – Medi-Cal Reimbursement Rates Introduced in the 2015-16 California Assembly legislative session, these bills would dramatically improve access to care for Medi-Cal beneficiaries by repealing recent cuts to Medi-Cal provider reimbursement rates; increasing reimbursement rates for most outpatient providers to Medicare levels, for both fee-for-service and Medi-Cal managed care providers; and increasing hospital Medi-Cal rates on a one-time basis and requiring annual increases thereafter. Medi-Cal is one of the lowest paying Medicaid programs in the country. Despite the fact that California now has an estimated 12 million people eligible for Medi-Cal (nearly one third of the state’s population), California pays the third-lowest reimbursement rate in the country (California Healthcare Foundation, March 2014). By the middle of 2016, it is estimated that California’s Medi-Cal population will have grown by over 4.6 million people since 2011. The state needs to ensure that expanded coverage translates into timely access to medical services. AB 637 (Campos) – POLST forms This bill would allow nurse practitioners and physician assistants, under physician supervision, to sign Physician Orders for Life-Sustaining Treatment (POLST) forms in an effort to increase utilization and to make a POLST an immediately actionable order. AB 1086 (Dababneh) – Assignment of reimbursement rights Would require Knox-Keene regulated health care service plans to honor assignment of benefit agreements, thereby sending any payment directly to the out-of-network provider when such an agreement is present. It also requires that assignment of benefits agreements contain certain information that will assist the consumer/patient in determining out-of-network cost exposure. AB 1434 (McCarty) – Health insurance prohibition on health insurance sales: health care service plans The bill seeks to close an existing loophole that allows Blue Cross of California and Anthem Blue Shield to choose the regulator with which to file their PPO products. This loophole has resulted in the General Fund foregoing more than $1 billion from 2004 to 2011. The bill also requires the Department of Finance, in consultation with DHCS, as a part of the annual budget process, to determine if the implementation of AB 1434 has resulted in increased revenues to the General Fund. If so, the equivalent amount of that increase shall be appropriated to DHCS for the purpose of increasing provider rates under the Medi-Cal program. SB 22 (Roth) – Medical residency training program grants Establishes a Graduate Medical Education Trust Fund that can receive contributions from private sources in order to provide grants to residency programs in areas with the greatest need. This bill is intended to serve as a vehicle for discussion among various health care stakeholders (physicians, provider groups, hospitals, clinics and health plans) about how to adequately and sustainably fund graduate medical education in light of inadequate funding levels from the federal government. SB 289 (Mitchell) – Telephonic and electronic patient management services This bill requires health insurance companies licensed in California to pay providers for telephone and electronic patient management telehealth services. Currently, reimbursement for these services vary. Plans often deny physician requests for coverage, depriving patients of a reasonable alternative to face-to-face physician evaluations. SB 563 (Pan) – Workers' compensation: utilization review This bill seeks to limit potential conflicts of interest by requiring employers and insurers to disclose payment methodologies for those involved in the process of reviewing and approving, modifying, delaying or denying requests by physicians related to providing medical services to injured workers. It will also look to limit the ability to reopen old cases with lifetime medical awards through utilization review to deny treatment plans that were already approved and settled. SB 781 (Allen) – Emergency room physicians Because emergency physicians see patients irrespective of their insurance status, they are not guaranteed a certain amount for treatment. This bill would create a system that provides the treating physician fair payment, with the insurer required to pay the amount of the 70th percentile of the Fair Health Database. If either the provider or the insurer disputes the payment, they must enter a mandatory, binding arbitration to determine whether the provider’s charges or the proposed payment by the insurer is “more” fair. For more information on these and other bills of interest to physicians, subscribe to CMA’s Legislative Hot List at www.cmanet.org/newsletters. March 24, 2015 General Medi-Cal, POLST, State Legislative Advocacy, Tobacco Tax, Workers' Compensation, Graduate Medical Education 0 0 Comment Read More »
Match Day keeps some new doctors in California, sends others out-of-state Friday, March 20, on National Match Day, California’s graduating medical students learned whether they can begin practicing medicine here – or if they must leave the state to begin their careers. The National Resident Matching Program matches graduating medical students with residency programs using a mathematical algorithm that pairs the rank-ordered preferences of applicants and program directors to produce a “best fit” for filling available training positions. However, this year, more than 41,000 medical school seniors and graduates applied for only 30,000 available residency positions. “Match Day is a pivotal point in a medical student’s career,” said California Medical Association (CMA) President, Luther Cobb, M.D. “Many students graduating from California medical schools want to continue their education and training by attending residency programs here. Unfortunately, because of funding restraints, there aren’t enough openings to accept them all.” Beth Griffiths, fourth-year medical student at UC San Diego School of Medicine, is one of the lucky ones. Griffiths matched her first choice – UC San Francisco – for an internal medicine residency, primarily focused on training primary care physicians. She hopes to practice primary care for adults in Northern California, focusing on caring for Spanish-speaking patients. “Unfortunately,” she says,” there is a tremendous shortage of physicians who are fluent in Spanish.” Griffiths is thrilled to stay in California to practice medicine. “I like the commitment to serving the underserved that is part of so many of our training programs,” she says. “I also hope to stay active in issues of public policy, which are so relevant to the practice of medicine and improvement of public health.” But although Griffiths will remain in California, many medical students will not. The federal government, through the Medicare program, has been the major funding source for residency programs. Regrettably, this funding has been frozen since 1997, despite California’s population growing over 10 percent in the same time. In addition, many residency program leaders say that funding received from Medicare and Medicaid does not fully cover the cost of even the current residency training slots, so sponsoring institutions such as teaching hospitals must absorb residual costs. That’s why CMA is sponsoring SB 22, authored by California State Senator Richard Roth (D-Riverside). The bill would establish a Graduate Medical Education Trust Fund that can receive contributions from private sources in order to provide grants to residency programs in areas with the greatest need. March 23, 2015 General Advocacy, Match Day, Residents and Fellows, Graduate Medical Education, Physician Workforce 0 0 Comment Read More »
Hundreds of California medical students learn where they will continue training Sacramento – Friday, March 20, 2015, is national “Match Day.” Hundreds of California medical students will learn whether they can begin their medical practice in state, or if they will be forced to leave California to complete their training to become fully licensed physicians. Medical students select a residency program based on the medical specialty they plan to pursue as well as the specifics of a program, which may include particular aspects of training or geography. “Match Day is a pivotal point in a medical student’s career,” said California Medical Association (CMA) President Luther Cobb, M.D. “Many students graduating from California medical schools want to continue their education and training by attending residency programs here. Unfortunately, because of funding restraints, there aren’t enough openings to accept them all.” The federal government, through the Medicare program, has been the major funding source for residency programs. Regrettably, this funding has been frozen since 1997, despite California’s population growing over 10 percent in the same time. In addition, many residency program leaders say that funding received from Medicare and Medicaid does not fully cover the cost of even the current residency training slots, so sponsoring institutions such as teaching hospitals must absorb residual costs. Senate Joint Resolution 7 calls on Congress and the President to lift the freeze on residency positions funded by Medicare, thereby creating a funding stream that will allow for the creation of more residency positions in California. “The long time federal freeze on funding new residency positions funded by Medicare has limited California’s ability to train primary care physicians in our own state to meet our needs. As California’s successful implementation of the ACA has sharply reduced the number of uninsured, it is imperative that Congress and the President lift the freeze so all patients can receive high quality primary care from highly trained physicians,” said Dr. Richard Pan, a pediatrician and State Senator representing Sacramento. Just last year, over 400 medical school graduates went “unmatched,” meaning they were unable to find a residency program to complete their training. "We greatly appreciate this resolution calling for improved funding for primary care Graduate Medical Education," said California Academy of Family Physicians President Del Morris, MD. "Our state’s family medicine leaders look forward to working with legislators on a wide range of strategies to address the primary care physician shortage and ensure that Californians will have access to the health care they need.” “Each year, we send hundreds of students out of state, or worse – leave them unmatched – because of the lack of available residency positions,” added Dr. Cobb. “With millions of newly insured patients having recently entered the health care delivery system, we need to increase the pipeline for new physicians in California.” Last year’s state budget was a step in the right direction, including $7 million for primary care residency slots. But, to train the hundreds of students graduating in California, more must be done. March 23, 2015 General Match Day, Medical Students, Residents and Fellows, Graduate Medical Education 0 0 Comment Read More »
State budget includes $7 million for new primary care residency slots Following the unprecedented grassroots advocacy by the physician and medical student community, the Legislature approved a state budget that includes $7 million for new primary care residency slots. The budget is now on Governor Brown's desk awaiting his signature. The California Medical Association is urging all physicians to contact the governor's office and urge him to maintain this critical funding, which will help California meet the increased demand for medical services now that millions of additional patients are insured under the Affordable Care Act. Three million dollars would be applied to expand the Song-Brown program to all primary care specialties (family medicine, internal medicine, obstetrics-gynecology and pediatrics). The additional $4 million will fund residency programs that wish to expand and train more residents. The budget act requires priority be given to programs that have graduates of California-based medical schools, reflecting the overwhelming data that physicians who obtain their medical degree and complete training in California are very likely to practice in the state. Although federal, state and private funds pay for graduate medical education (GME), federal contributions through Medicare contribute the bulk, about $9.5 billion annually nationwide. Unfortunately, this federal funding source has been frozen since 1997 despite California’s population having grown by 20 percent in the same timeframe. Our state has a trove of primary care physicians who want to train here, including those who have graduated from California medical schools, but who are forced to leave the state because training slots at medical residency programs are limited. Given the inaction by the federal government to address this issue coupled with the immediate need to train additional physicians, California needs to take the lead to ensure our state has an adequate physician supply. Unfortunately, California has only 26.3 residents per 100,000 people, severely lagging behind the national average of 36.6. The California Medical Association (CMA) is thrilled with the inclusion of this funding in the state budget and sees it as a significant achievement, representing the first real investment of state funding to support GME. Now we must convince the Governor that this important funding should be maintained. In California, the Governor has the power to reduce expenditures in the state budget (often referred to as “line-item veto” authority), while signing the underlying budget act. We need to demonstrate the overwhelming support this funding has and argue why it’s particularly important given California’s ongoing physician shortage. We ask that you and your colleagues call or fax the governor's office or visit his website and urge him to support increased funding for GME. Phone: (916) 445-2841 Fax: (916) 558-3160 Email: http://govnews.ca.gov/gov39mail/mail.php (Choose "Budget Proposal 2014-15" from the drop down menu.) More information, including talking points and a sample letter are available in CMA's grassroots action center. June 19, 2014 General Residents and Fellows, State Legislative Advocacy, Graduate Medical Education 0 0 Comment Read More »
