Children’s Hospitals Struggle to Train Enough Specialists to Keep up with Growing Demand
CHOP, UPMC and St. Christopher’s Hospital for Children Will be Hit by Cut
Washington DC- Today U.S. Senator Bob Casey (D-PA) called on President Obama to preserve funding that benefits Pennsylvania’s children’s hospitals. The Children’s Hospital of Philadelphia, the Children's Hospital of Pittsburgh of UPMC and St. Christopher’s Hospital for Children would be hit by severe cuts to the Children’s Hospital Graduate Medical Education (CHGME) program, which has provided funding to physicians who care for children.
“Pennsylvania has some of the best children’s hospitals in the world, said Senator Casey. “Even at current annual funding levels, children’s hospitals struggle to train enough pediatricians and pediatric specialists to keep up with the growing demand. Additional cuts put at risk gains that have been achieved under the program and threaten the pediatric workforce in Pennsylvania.”
For over a decade, the CHGME program has provided children’s teaching hospitals with federal support comparable to what other teaching hospitals receive through Medicare. Pennsylvania has three hospitals that would be affected by the cut: The Children’s Hospital of Philadelphia; Children's Hospital of Pittsburgh of UPMC and St. Christopher’s Hospital for Children.
The CHGME program has increased the number of pediatric providers, addressed critical shortages in pediatric specialty care, and improved children’s access to care. The children’s hospitals that receive CHGME, less than one percent of all hospitals, train nearly half (49 percent) of all pediatricians, including more than 45 percent of general pediatricians and 51 percent of pediatric specialists.
The full text of Senator Casey’s letter to President Obama is below:
Dear Mr. President:
I write to express my disappointment in your FY 2014 budget recommendation of $88 million in funding for the Children’s Hospital Graduate Medical Education (CHGME) program.
The CHGME program represents the most important federal investment in strengthening the pediatric workforce and has been a major success. It has increased the number of pediatric providers, addressed critical shortages in pediatric specialty care and improved children’s access to care. Today, the children’s hospitals that receive CHGME, less than one percent of all hospitals, train nearly half (49 percent) of all pediatricians, including more than 45 percent of general pediatricians and 51 percent of pediatric specialists.
The CHGME program rightfully enjoys broad bipartisan support in Congress and I, like many of my colleagues, appreciated the White House’s decision last year to restore funding for the program in the FY 2013 budget after proposing in the previous year to eliminate CHGME. However, the proposed funding level of $88 million in the FY 2014 budget submission is woefully inadequate, representing only approximately one-third of the current annual funding level. In addition, I believe the Administration’s assertion that CHGME funding should only support “direct” medical education costs is misguided. This would run counter to the reasons Congress enacted CHGME, and negatively impact the ability of children’s hospitals to meet pediatric workforce needs.
The indirect medical education (IME) payment adjustment reflects the higher patient care costs of teaching hospitals relative to non-teaching hospitals and is measured by a teaching hospital’s teaching intensity, i.e. resident to bed ratio. On average, children’s hospitals have twice the teaching intensity as teaching hospitals overall, making the inclusion of IME, a critical measure of the costs of teaching, appropriate. Eliminating support for indirect costs would mean failing to recognize the higher patient care costs of the special services provided at teaching hospitals, including freestanding children’s hospitals, and the unique training related to those services that occur at these institutions. Elimination of IME funding would cause teaching hospitals to eliminate many of the specialized services that make them unique and eliminate the training opportunities they afford our future physicians.
Funding for the CHGME program has already been significantly reduced in recent years. Appropriations for the program have gone from $317.5 million in FY 2010 to $265.2 million in 2012. Even at CHGME’s current annual funding level, children’s hospitals struggle to train enough pediatricians and pediatric specialists to keep up with the growing demand. Additional cuts put at risk gains that have been achieved under the program and threaten the pediatric workforce pipeline.
I recognize the budgetary challenges we face and the responsibility to carefully consider the Nation’s spending priorities. However, CHGME is vital to the health care of all American children and should be supported accordingly in the President’s budget. I look forward to working with my colleagues in Congress to once again secure the strongest possible appropriation for this program.
Sincerely,
Robert P. Casey, Jr.
United States Senator
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