Medicare Graduate Medical Education Affiliation Agreements (MGMEAAs) are formal agreements between two or more eligible teaching hospitals that allow for the sharing of Medicare GME funding caps. These agreements optimize residency and fellowship training opportunities, maximize Medicare reimbursement, and foster collaboration between hospitals and academic institutions. By leveraging these agreements, hospitals can better address workforce shortages, enhance clinical training, and contribute to the overall health of their communities. With over 400 hospitals currently participating in these agreements, MGMEAAs have become a crucial tool in shaping the future of Graduate Medical Education.
Eligibility and Key Requirements
To participate in an MGMEAA, hospitals must meet specific eligibility requirements set by the Centers for Medicare & Medicaid Services (CMS). Hospitals must be eligible for Medicare GME payments and establish a formal written agreement that outlines the terms of cap-sharing, specifying the number of full-time equivalent (FTE) resident positions each hospital is allocating or receiving. The MGMEAA must be in place for a minimum of one academic year and submitted to CMS before the July 1 deadline for the upcoming training year. Participating hospitals are also required to comply with CMS reporting requirements to ensure accurate tracking of resident FTEs and Medicare reimbursement claims. The agreement must also clearly define the adjustments to direct and indirect FTE caps for each hospital involved.
These agreements are only available to hospitals that meet the following conditions:
They must be located within the same urban or rural area or in a contiguous area and meet the rotation requirement outlined in CMS regulations.
If hospitals are not in the same or contiguous area, they must still meet the rotation requirement and be jointly listed as either the sponsor, primary clinical site, or major participating institution
They must have a shared rotational arrangement, meaning residents train at two or more hospitals as part of the same residency program.
By adhering to these criteria, hospitals can leverage MGMEAAs to strategically redistribute resident positions and enhance their residency programs.
Strategies for Maximizing MGMEAAs
Advancing Residency Training and Education
MGMEAAs serve as a powerful tool for hospitals looking to enhance their GME programs, optimize Medicare reimbursement, and improve their learning environments. By strategically leveraging these agreements, institutions can strengthen their residency training programs while addressing workforce shortages and financial challenges.
If you are considering an MGMEAA for your organization, Germane Solutions can help assess your eligibility, develop a strategic plan, and connect you with a compatible hospital partner to maximize your Medicare reimbursement and educational impact. Contact us today to explore how an MGMEAA can align with your institution’s goals.
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