The rules for creating a Teaching Health Center (which I discussed before here and here) have been posted. If you are thinking about applying, note that the deadline for submission is December 30, 2010 at 8:00 pm ET. Here is a link to the application page. Below are some excerpts from their announcement with my commentary.
The government is willing to pay for direct expenses associated with sponsoring an approved graduate medical education training program and indirect expenses associated with the additional costs relating to teaching residents in such programs out of this money. This money will go directly to the THC instead of being filtered through a hospital. Although the program period is one year, it is HRSA’s intent to fund qualified THCs for the entire five year THCGME program period pending satisfactory performance of awardees and availability of federal funds (putting the THC at risk if congress changes its mind but also putting the THC on notice that they may not take advantage of this progrma to continue to create traditional residency training programs). Funding can only be used for the costs of new residents in a newly-established THC or an expanded number of residents in a pre-existing THC (this is not to pay for residency slots currently being paid for but to try and create new slots which is a problem because many current slots are underfunded). These payments will be as much as $150,000 per resident per year (which shows you how much it costs to train residents).
Payments must directly support the THC ambulatory training site (to try to keep hospitals from taking the money and re-purposing it). If a THC-affiliated teaching hospital receives GME funding from Medicare or other sources for the new THC residents, the THC cannot claim that portion of the time for HRSA GME payments (you can’t double dip).
Eligible entities include community-based ambulatory patient care centers that operate a primary care residency program in high-need, underserved communities. (This will move training into the community where it belongs).
Training Program Eligibility
Only specific residency training programs program (family medicine, internal medicine, pediatrics, internal medicine-pediatrics, obstetrics and gynecology, psychiatry, general dentistry, pediatric dentistry, and geriatrics) are eligible (Hospitals can’t use it to create radiology residencies).
Successful THCs have common elements, foremost of which is an institutional commitment to a dual mission of medical education and service to an underserved patient population, including underrepresented minority and other high risk populations. In addition, there is significant patient- and community-based input into THC operation and management; and THCs have also demonstrated progress toward innovative models of patient care delivery such as the patient-centered medical home, implementation of electronic health records, population-based care management, and use of interdisciplinary team-based care (HRSA is not interested in funding the same old stuff)
Measureable outcomes will include practice patterns of graduates such as whether they are providing primary care, and whether they are serving in safety net settings one and five years after completion. It may also include outcomes such as creation of interprofessional teams that provide person-centered care, improvement in quality parameters, improvement in patient outcomes, and improvement in use of electronic medical technology. Not only does the successful applicant have to say they are going to do good things, they have to actually do them.
I look forward to seeing the applicants and how they propose to change our training…