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Psychology Training Programs Need GME Funding to Preserve Patient Care
Congress: Include psychologists’ educational training programs in
Medicare GME funding
May 1999
Government Relations
Practice Directorate
For more information: E-mail
The Problem For Patients:
Psychologists are currently ineligible for GME funding. While
physicians, nurses, and at least 19 allied health care professionals, including dietetic
interns, physical therapists, radiographers and clinical pastoral counselors, are eligible
for GME funding, psychologists do not receive any funding.
Hospitals can no longer bear the costs of running psychology training
programs . . . Hospitals and other Medicare facilities pay for
and run psychology educational training programs with no GME reimbursement. This lack of
funding, coupled with loss of income due to changes in the health care delivery system,
has forced many hospitals to reduce financial support to train psychologists.
And cutbacks in psychology training programs mean less services for
patients . . . Psychology students provide a range of key, often
unique, therapeutic, primary care, and diagnostic services directly to Medicare
beneficiaries. Their services are particularly important for hospitals and other Medicare
facilities in rural and underserved areas, where physicians are not available to provide
similar services.
Services which patients need and use. Hospitals
and other Medicare facilities place their psychology students in a wide range of settings
to render a broad range of services to patients and to collaborate with a multitude of
other health care professionals in multidisciplinary contexts. These settings include:
psychology and psychiatry departments, pain management units, physical and mental
rehabilitation units, community and preventive health departments, and cardiology,
surgery, anesthesiology and other medical specialty areas, to name a few.
The Solution For Patients:
GME funding to hospitals and other Medicare facilities for
psychologists’ professional educational programs will preserve high quality
psychological care for patients . . . Funding the training of psychologists, as with
other health care professionals, encourages their participation in the Medicare program
first as interns and, upon graduation and licensure, as health care professionals who
deliver important diagnostic and treatment services to Medicare beneficiaries.
At a very reasonable cost to the program. At
most, the cost to Medicare to reimburse hospitals and other Medicare facilities for the
hundreds of psychology training programs that they run would be about $15 million annually.*
Certainly, $15 million is a modest sum, and a miniscule amount compared to the $2 billion
spent annually for direct medical education.
HCFA Is Not Listening:
Congress has already requested HCFA to fund psychology professional
educational training programs . . . In the "Balanced Budget Act of 1997"
report language, Congress urged HCFA to include psychologists under its authority to
reimburse the training of allied health professionals. Psychology training programs
already meet the current eligibility requirements for such GME reimbursement.
But after nearly two years, HCFA has yet to implement Congress’s
clear request. It is time for Congress to mandate psychology GME
funding through statute before patient care is further eroded.
* Based on an extensive survey of psychology
internship programs, the APA estimates that the median annual cost to a hospital to run an
entire psychology internship training program is about $120,000. With an estimated 375
hospital settings that house psychology internship training programs in the U.S., the
cumulative cost to operate all of these programs is about $45 million annually. Medicare
GME would reimburse the appropriate portion of this amount, related to services provided
to Medicare beneficiaries, which a sample of our internship programs have indicated would
represent about 30% of the total, or about $15 million.
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