A new analysis estimates that the Teaching Health Center Graduate Medical Education (THCGME) program could yield up to $1.8 billion in public program savings over the course of five years, from 2019 to 2023. The THCGME program, which began in 2011 and is administered by the Health Resources and Services Administration (HRSA), aims to increase the number of primary care residents training in community-based care sites like community health centers. Currently, 56 Teaching Health Centers (THCs) in 23 states train residents in family medicine, internal medicine, pediatrics, psychiatry, ob-gyn and dentistry. Current federal authorization and funding for the THCGME program expire on September 30, 2019. The President’s proposed FY2020 budget includes two years of additional funding for teaching health centers.
This analysis shows how the THCGME program has the potential to significantly reduce Medicaid and Medicare costs – both during and after clinician training – while providing high quality primary care in medically underserved locations. The authors used recent research that examines the cost-effectiveness of health center-based care to determine the potential savings associated with the program. The analysis was conducted by researchers at the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University Milken Institute School of Public Health, led by Candice Chen, MD, MPH, along with colleagues Leighton Ku, PhD, MPH; Marsha Regenstein, PhD, and Fitzhugh Mullan, MD.
Residents based in community health centers are trained to provide high-quality, cost-efficient care; patients who receive most of their care in community health center settings have lower medical expenditures overall than those who get their care in other settings. In addition, research shows that residents trained in lower-spending regions are more cost-efficient in their subsequent practice, with lower average spending per patient, per year. The authors analyze both the savings produced by THC residents during their training at community health centers, as well as the savings associated with the more cost-efficient practices of physicians who graduate from THC training. Taken together, the potential savings to public programs over the 2019-2013 period totals $1.8 billion – $1.5 billion in Medicaid savings and $284 in Medicare savings.
The goal of the THCGME program is not only to provide expanded opportunities for training, but to improve access to high-quality care by increasing the number of well-trained physicians and dentists practicing in underserved communities after they complete that training. A continued investment in the THCGME program has the potential to yield better access to high-quality primary care and to bend the cost curve, by providing substantial long-term health care cost savings.
The report, “Examining the Cost Effectiveness of Teaching Health Centers,” is now available on our website.
Read the full report here.