As a continuation of our commitment to supporting dentistry and podiatry residency programs, Germane Solutions is here to provide a deeper understanding of the unique available funding opportunities for these programs. Unlike their counterparts in other medical fields, dental and podiatry programs enjoy distinct reimbursement structures, offering both challenges and advantages for hospitals looking to expand their residency offerings.
Flexibility in Residency Caps and Reimbursement for Dental and Podiatry Programs
One of the significant differences between dental/podiatry residency programs and other healthcare residency programs is that they are not subject to the standard Indirect Medical Education (IME) and Direct Graduate Medical Education (DGME) caps. This flexibility allows hospitals to receive full funding for dental and podiatry residents without worrying about exceeding their current IME and DGME caps.
Hospitals that are already training residents beyond their established cap can still train additional dental and podiatry residents, claim, and receive reimbursement for these extra trainees.
Even hospitals located in urban areas that are outside of their cap development period can still launch and receive full funding for new dental and podiatry residency programs.
This presents a unique opportunity for hospitals seeking to expand their residency offerings without the constraints typically imposed by caps in other specialties.
Setting the PRA: A Crucial Step for New Dental and Podiatry Programs
For hospitals that are introducing dental or podiatry residency programs for the first time, one crucial consideration is setting the Per Resident Amount (PRA). While setting the PRA will not impact the cap development period, it is essential to ensure appropriate funding for these new programs.
PRA and Non-Teaching Hospitals: Dental and podiatry residents training in new programs do not trigger an FTE cap for non-teaching hospitals (those that have not previously trained residents). However, a PRA will still be established when the hospital trains at least 1.0 FTE regardless of program newness or specialty. The PRA plays a key role in determining the amount of DGME funding a hospital will receive in perpetuity.
PRA Considerations: It is important to note that the PRA is permanent and cannot be modified or reset. Hospitals that are new to training residents must take extra care to document and claim sufficient costs to ensure that their PRA is set at an adequate level. However, a hospital doesn't necessarily receive reimbursement for its fully recognized PRA. The value that is used in the calculation for DGME payments is the lower of 1) the reported cost per resident and 2) the weighted average PRA of all teaching hospitals located in the same geographic wage area.
FTE Threshold for PRA: A PRA can only be established once a hospital has at least 1.0 FTE of dental or podiatry residents in training. This requirement was established in 2020, and hospitals will need to ensure they meet this threshold before initiating PRA claims.
Strategic Planning for Success
With these funding structures in mind, it’s essential for hospitals to strategically plan the commencement of dental and podiatry residency programs. By carefully managing PRA setting, understanding the reimbursement timelines, and maximizing the potential of training additional residents beyond the IME and DGME caps, hospitals can leverage these unique funding opportunities to grow their programs successfully.
Germane Solutions is dedicated to helping hospitals navigate these complexities and ensure the financial sustainability of new residency programs. Whether you're launching a dental or podiatry program for the first time or looking to optimize your current offerings, we’re here to support your journey to success.
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