A big tuition hike at the U?

http://www.sltrib.com/ci_8620810

Proposed Medicaid rule could cut U. graduate doc-training funds

By Lisa Rosetta
and Brian Maffly
The Salt Lake Tribune

Graduate medical education in Utah may take a one-two punch.

The Centers for Medicare and Medicaid Service, CMS, is proposing a rule that would say money spent training doctors would no longer be reimbursed by Medicaid. In Utah, that would mean $19.3 million that helps fund residency programs at teaching hospitals could disappear.

The University of Utah School of Medicine alone could lose $12 million - at the same time it is bracing for an $11 million loss in revenue from another rule change limiting public hospital reimbursements.

"We are in an absolute worst possible situation," said dean David Bjorkman.

Spreading the $11 million hit among the school's 408 medical students would raise tuition by $27,000, putting Utah's tab on par with the costliest schools in the nation, the dean noted.

"That's not right for the state and it's not right for medical education to price so many people out," Bjorkman said.

Critics say the CMS proposal is an abrupt reversal for a federal agency that has for decades covered graduate medical education as a cost of providing hospital services and patient care.

And it comes at a time when Utah, like the rest of the country, is struggling to train enough physicians to keep pace with a growing population's health care needs.

Barbara Viskochil, director of University Health Care's Department of Medicare and Medicaid Services, wrote to CMS last summer and urged it to rescind the proposed rule.

"Educating future physicians and other health care professionals has never been more important, given the numerous studies predicting a physician shortage in the near future," she wrote.

David Squire, executive director of the Utah Medical Education Council, said the state only trains 20 percent of its physician workforce - a number that could shrink with the impending cuts.

"We will be disproportionately hurt in this state," he said. "If these cuts take place today, there is going to be a pipeline delay. We'll immediately hire that many less interns and residents."

Primary Children's Medical Center could lose about $3 million, hurting its ability to offer residency slots, said Bill Barnes, director of government relations. Losing even one resident would be big blow to the state, which is "way under-supplied with pediatricians," he said.

The hospital, which offers 52 residencies, would "try to find money elsewhere to cover it," Barnes said. "It just would make it a lot more difficult to try and manage it."

lrosetta@sltrib.com
bmaffly@sltrib.com