Financial Implications of the Updated ACGME Requirements for Emergency Medicine Residency Programs

The newly posted 2026 Emergency Medicine (EM) Program Requirements by the Accreditation Council of Graduate Medical Education (ACGME) creates both financial challenges and opportunities for programs and hospitals. The complexity of the federal government funding of GME through Centers for Medicare and Medicaid Services (CMS) makes it difficult for program and institutional Graduate Medical Education (GME) leaders to identify the financial implications of changes in clinical EM operations and curriculum design. Institutional initiation of a change in program format is best implemented with an understanding of the hospital's financial priorities. In this concept paper, we discuss steps to clearly identify the financial impact of the EM residency program format on CMS funding and program complement size. We also provide clarifications on the new ACGME required programmatic changes and their impact on EM residency funding.