Healthcare News of Note: 100 hospitals receive funding for new physician residency slots to boost healthcare access

• CMS distributed 200 Medicare-funded physician residency slots to 100 hospitals, aiming to bolster healthcare access in areas with a shortage of qualified professionals.
• Overall cancer mortality has dropped 33% since 1991, averting an estimated 3.8 million cancer deaths, according to the American Cancer Society’s latest report.
• Patients’ ratings of specialist care were markedly higher when the specialist and referring primary care physician trained at the same time at the same institution.

Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.    

1. New residency slots are targeted toward primary care and mental health in areas with health professional shortages

As part of its effort to improve health equity in U.S. healthcare, CMS this month awarded 200 Medicare-funded physician residency slots to 100 hospitals in underserved communities.

In 2020, year-ending federal spending legislation established that 1,000 slots would be awarded to qualifying hospitals over a five-year period beginning in FY23. In awarding the first 200 positions, CMS prioritized hospitals that are in designated health professional shortage areas (HPSAs) for primary care and mental health.

Among the new positions, 125 are for primary care physicians and 20 are for psychiatric specialists, CMS noted in a news release. Hospitals can use the slots starting July 1.

“Supporting the training of new primary care and psychiatry residents demonstrates essential progress toward improving access to critical services, including those necessary to address the mental health crisis, in rural and underserved communities,” the release states.

Qualifying criteria

To qualify for new slots, hospitals must apply and meet one of the following criteria:

• Be in a rural area
• Have a pool of residents that exceeds their graduate medical education (GME) cap
• Be in a state with a new medical school or branch campus
• Be in a geographic HPSA

At least 10% of the positions must go to hospitals that meet all of those conditions, and among the individual criteria, CMS is prioritizing HPSA scores as a way to distinguish between qualifying applicants.

In the Round 1 awards, the largest number of direct GME slots awarded to a single hospital was 4.67 (to Cabell Huntington Hospital in West Virginia, which received the same number of indirect medical education, or IME, slots). A list of the 100 Round 1 recipients can be downloaded in a ZIP file.

The second set of slots will be awarded for FY24, with an application period running through March 31, 2023. Hospitals can apply for direct GME slots, IME slots or both, except that hospitals can apply for IME slots only if they’re paid under the Medicare inpatient payment system.

The link to the application is available through the Medicare Electronic Application Request Information System.

— Nick Hut, HFMA senior editor

2. Overall cancer deaths in the US decline, but there’s a concerning increase in prostate cancer, says American Cancer Society

“Overall cancer mortality has dropped 33% since 1991, averting an estimated 3.8 million cancer deaths,” according to the American Cancer Society’s Cancer Statistics, 2023 report.

“This progress increasingly reflects advances in treatment, which are particularly evident in the rapid declines in mortality (approximately 2% annually during 2016 through 2020) for leukemia, melanoma, and kidney cancer, despite stable/increasing incidence, and accelerated declines for lung cancer,” wrote the report authors.

“Substantial changes in cancer prevention and screening in the last decade” drove “two of the most critical findings,” according to the report:

• 1. A 65% reduction in cervical cancer incidence in women ages 20-24 from 2012 through 2019, in the wake of the introduction of the human papillomavirus vaccine.
• 2. A 3% per year (from 2014 through 2019) increase in prostate cancer, which is the second leading cause of cancer death for men in the U.S. This “after two decades of decline,” noted the authors, adding, “Most concerning is that this increase was driven by the diagnosis of advanced disease.”

Projected cancer cases this year

Based on ACS data, here are some of the projections of cancer cases and deaths for 2023:

• There will be nearly 2 million (1,958,310) new cancer cases and 609,820 cancer deaths in the United States.
• The most diagnosed cancers for both sexes combined will include breast (300,590), prostate (288,300), lung and bronchus (238,340), colorectum (153,020) and melanoma of the skin (97,610).

Projections for many additional types of most diagnosed cancers for both sexes are listed at the ASC Cancer Statistics Center.

HFMA related content

An April 15 Voices in Healthcare Finance podcast featured Andrew Hertler, chief medical officer at New Century Health, who discussed what healthcare organizations can do to catch up on patients’ missed cancer screenings. He also shared new developments in oncology that could see patients receiving treatment at home or doing virtual follow-up care.

The Aug. 29 Healthcare News of Note blog’s top story was “Cancer is now the top driver of large employers’ healthcare costs,” which detailed, in part, how 13% of employers reported more late-stage cancers among employees, and another 44% anticipated the same type of increase in the future.

3. The physician-peer relationship improves the patient’s experience with specialty care

“Patients’ ratings of specialist care were markedly higher when the specialist and referring PCP [primary care physician] trained at the same time at the same institution, particularly when in the same year, and were thus more likely than other PCP-specialist dyads to have a strong peer relationship established,” according to a study published Jan. 3 in JAMA Internal Medicine.

“Co-training was not only associated with a more friendly and concerned manner but also clearer explanations, greater engagement in shared decision-making, and changes in prescribing by specialists,” wrote the study authors.

The authors noted the “findings are consistent with the notion that peer relationships can motivate physicians to deliver improved care through peer or audience effects; when physicians believe their work may be scrutinized or recognized by peers, they may aspire to higher standards. Referrals from familiar PCPs should make alignment of values more visible, thereby establishing stronger peer accountability and offering an opportunity for the specialist to demonstrate what is valued by the related PCP-specialist dyad, including competence and patient-centered care.”

Study results include increases of:

• 9 percentage points in adjusted composite patient rating of specialist care
• 1.6 percentage points in adjusted proportion of specialist visits in which patients were prescribed a medication
• 1.2 percentage points in adjusted proportion of visits with imaging ordered   

The study was based on 9,920 specialist visits for 8,655 patients from 2016 to 2019 in a large health system, and analysis was completed from March 2020 to October 2022.