VCU Health System CEO Testifies Before Congressional Committee About Proposed Medicaid Regulatory Changes

Dr. Sheldon Retchin said that elimination of graduate medical education payments will reduce access to healthcare

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A proposal to eliminate Medicaid graduate medical education funding would endanger the ability of teaching hospitals to maintain their mission of training physicians as well as reduce the access of millions of Americans to healthcare, the head of one of the largest academic medical centers in Virginia told a congressional panel on Thursday.

"The Medicaid-proposed rule on GME represents surprising disregard for the future viability of our nation's healthcare system," said Dr. Sheldon M. Retchin, CEO of the Virginia Commonwealth University Health System and vice president for VCU Health Sciences. "The timing of the proposal is problematic, as the United States faces a looming physician shortage in conjunction with the rise in the healthcare demands of baby boomers.

"The mission of our teaching hospitals to train the next generation of physicians is more important than ever, yet training programs face severe funding cuts. Eliminating Medicaid GME funding would be dangerously shortsighted," he said.

Retchin testified before the House of Representatives Committee on Oversight and Government Reform, chaired by Rep. Henry Waxman, D-Calif., at a hearing about the Bush administration's regulatory actions on Medicaid and its affects on patients, doctors, hospitals and states.

Retchin spoke on behalf of the Association of American Medical Colleges, AAMC, which represents about 400 major teaching hospitals and health systems, 126 accredited U.S. medical schools and 94 academic and professional societies.

He told the committee that teaching hospitals care for 42 percent of Medicaid patients and in 2005 provided nearly one-half of all hospital charity care, even though they account for just 20 percent of the nation's hospitals.

"The nation's major teaching hospitals provide a disproportionate amount of healthcare services for Medicaid beneficiaries and the uninsured, while simultaneously maintaining core missions of medical education, biomedical research and innovative patient care," Retchin said. "It is important that the Medicaid program and states be allowed to maintain their financial commitments to teaching hospital missions."

Retchin said that GME payments over the past 20 years have helped teaching hospitals provide clinical education for future physicians, critically important given current and future physician shortages. He said reductions in Medicaid GME payments may lead to reductions in training positions for the physicians who care for Medicaid and other patients.

"Most of the uninsured and Medicaid beneficiaries are hard-working Americans who are either self-employed or are employed in small businesses that cannot afford healthcare coverage for their employees.

"Without the nation's safety net – its major teaching hospitals – many of our most vulnerable citizens would have fallen. With 47 million Americans uninsured and another 40 million on Medicaid, the safety net is stretched tight and teaching hospitals are holding the corners," Retchin said.