Addressing the primary care workforce crisis.

Area of Science:

• Health Policy
• Medical Education
• Primary Care Workforce

Background:

• The US primary care system faces a critical physician shortage.
• Medical homes and accountable care organizations depend on a robust primary care workforce.
• Current graduate medical education (GME) funding models may not adequately incentivize primary care training.

Purpose of the Study:

• To propose a policy incentivizing teaching hospitals to increase primary care physician (PCP) production.
• To align GME funding with national primary care needs.
• To explore financial benefits for hospitals producing PCPs.

Main Methods:

• Proposal based on 2014 Institute of Medicine recommendations.
• Suggests Centers for Medicare & Medicaid Services (CMS) reward hospitals with >30% of graduates entering primary care.
• Policy mechanism: additional payments or release of withheld funds.

Main Results:

• The proposed policy could incentivize hospitals to retain GME funding.
• Increased PCP production benefits hospitals under fee-for-service and risk-based contracts.
• A 30% PCP graduate target is proposed.

Conclusions:

• Policy intervention is needed to address the primary care physician shortage.
• CMS can incentivize PCP training through GME funding adjustments.
• Hospital financial models can be leveraged to support primary care workforce development.