The BBA may have yielded other unintended consequences as well. This paper covers the GME provisions of the BBA and their effects on the training of the nation's residents. It discusses the concerns of financial burden expressed by some, and examines actual data to determine if these fears are objectively founded. Some of the effects on primary care and rural practice are examined. The GME training of physicians and other health professionals in teaching hospitals is key to providing the nation with its supply of high-quality physicians, as well as enhancing the quality of care provided to hospital patients.
Teaching hospitals are also in the forefront of medical research and technological innovations.
They serve a disproportionately large number of patients who are poor, very sick and uninsured. Medicare payments to teaching hospitals were designed to create incentives for teaching hospitals to serve Medicare beneficiaries, as well as to support the training of physicians to meet beneficiaries' medical needs. Medicare makes two types of payments to support training programs in teaching hospitals for physicians. The DME and IME payments provided a strong incentive to hospitals to continue increasing their number of residents. Residents, for whom reimbursement is obtained from Medicare, provide services inexpensively and more flexibly than full-priced physicians and nurses.