Measuring Value in Internal Medicine Residency Training Hospitals Using Publicly Reported Measures

Area of Science:

• Medical Education
• Health Services Research
• Health Economics

Background:

• Graduate medical education (GME) currently lacks robust metrics to evaluate resident preparedness for delivering high-quality, cost-conscious patient care.
• Assessing the integration of value-based healthcare principles into residency training programs is crucial for future physician practice.

Purpose of the Study:

• To develop and validate metrics for assessing high-value care training within internal medicine residency programs using publicly available data.
• To compare internal medicine residency programs based on their performance in high-value care training.

Main Methods:

• Constructed program-level value training scores utilizing Centers for Medicare & Medicaid Services Value-Based Purchasing (VBP) Program data on hospital quality and cost-efficiency.
• Examined correlations between these program-level scores and measures of high-value care training from the Association of Program Directors in Internal Medicine Annual Survey using logistic regression.

Main Results:

• An increase in program-level VBP scores correlated with increased agreement among residency directors that GME programs should contain healthcare costs (aOR 1.18, P = .04).
• Higher VBP scores were also associated with program directors' agreement that faculty model high-value care (aOR 1.07, P = .03) and that residents are prepared for high-value medical decisions (aOR 1.07, P = .09).

Conclusions:

• Publicly reported clinical data, specifically from the VBP Program, provide valid and reliable measures for assessing the value-based training component of GME.
• These findings support the use of objective, public data to evaluate and improve the quality and cost-effectiveness of medical residency education.