In this episode, Christina Brown, BESLER’s Director of Reimbursement Services, provides us with a glimpse into BESLER’s next free live Webinar, Maximize the Accuracy of IME/GME, presented live on Wednesday, February 12, at 1 PM ET.
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Learn how to listen to The Hospital Finance Podcast® on your mobile device.Highlights of this episode include:
- What we will be discussing in the webinar
- How IME and GME plays a part in what hospitals will get reimbursed
- If interns and residents for all programs get reimbursed through the cost report
- IME/GME notable issues
- Nursing allied health education
Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome back Christina Brown, BESLER’s Director of Reimbursement Services. In this episode, Christina will provide us with a glimpse into BESLER’s next free live webinar, Maximize the Accuracy of IME/GME, that she’s presenting live on Wednesday, February 12th, at 1 PM, Eastern Time. Welcome back, and thank you for joining us, Christina.
Christina Brown: Thanks, Kelly. It’s always a pleasure.
Kelly: Yes, it is. Well, let’s go ahead and jump in today. So, can you tell us what kinds of things you’ll be discussing in this webinar? Is it more for those with advanced knowledge of reimbursement, or will you be covering the basics?
Christina: Kelly, I’m glad that you asked that. So, this webinar will be geared toward those with all levels of reimbursement knowledge. So given industry trends where those with advanced knowledge are likely close to retirement age, we do try very hard to make all of our webinars appropriate for all levels of reimbursement knowledge, meaning that there will likely be a little bit of something for everyone on this one. Just to get a bit into the specifics on what will be covered, I’m going to kick us off with some of the basics of IME and GME by just level setting with defining key terms related to reimbursement. As we all know, CMS loves acronyms, so I will expand on many of those that are related to medical education. For example, how IME is indirect medical education and DGME is direct graduate medical education. And they’re both payments that are related to the medical education reimbursement for hospitals with certain teaching programs. And then once I lay that foundational knowledge of defining the many key terms, I’ll expand upon what areas are impacted in the Medicare cost report. And then next, I’ll make mention of some notable issues related to reporting interns and residents. And then I’ll conclude with some important things to review to ensure accurate reporting.
Kelly: Wow, sounds like you’re going to cover a lot there. You mentioned the cost report and payments. Does that mean that IME and GME play a part in what hospitals will get reimbursed?
Christina: Kelly, that’s actually a very accurate assessment. But to be more specific, there are many components related to medical education reimbursement that are vital in what a hospital gets reimbursed for these programs. And some of these areas I’ll discuss will be directly related to specific worksheets on the cost report and what types of things should be considered or reviewed when making entries to the applicable cost report worksheets. And during the discussion of the worksheets, I’ll also touch on the importance or financial significance of each worksheet and what it plays when it comes to reimbursement. And as with most important areas of the cost report, we will begin by discussing worksheet S-2. Then we’re going to move on to the areas where the impacts are calculated by going into the specifics of the applicable lines as it relates to worksheets like E part A, E-3, and E-4.
Kelly: Wow, you’re really going to cover some content there. So do all interns and residents for all programs get reimbursed through the cost report?
Christina: Well, wouldn’t it be great if CMS were that generous and made it that easy?
Kelly: Right.
Christina: Unfortunately, that is not the case. CMS does not reimburse for all interns and residents. Programs must be approved and meet certain criteria. And after that, the amount reimbursed depends on a number of variables, like per resident amounts, where and what services are being provided, the resident-to-bed ratio, FTE cap information, as well as other determining factors. But rest assured, I will touch on a number of these variables during the webinar.
Kelly: So other than entry into the cost report, you also mentioned notable issues. Can you expand on what you mean by that?
Christina: Yeah, no problem. So having a medical education program has many benefits for the community it serves, as well as some potential for additional reimbursement. However, there are definitely a few things to consider other than where we plug the numbers into the cost report. Namely, there are some of the issues that I just mentioned that affect what can be put on the cost report, as well as factors outside the cost report that drive the amount of reimbursement. These would be things like the method and requirements for accounting intern and resident FTEs, the number of available beds, understanding the cap logic, especially when there are new programs being built, and also any Medicare Advantage implications. And these are the types of issues that I will briefly touch on during the webinar as well.
Kelly: Wow, that’s a lot to consider. Do all the issues you just mentioned play a role in the reimbursement the hospital receives for intern and resident programs?
Christina: Yes. So, believe it or not, Medicare has a very specific way that it calculates reimbursement for programs reported on the cost report. And medical education is no different. So, to answer the question, I would say absolutely. All of the issues that I cover on the webinar do have some impact, either directly or indirectly to the amount of reimbursement a hospital receives. So, for example, understanding the cap logic, especially as it relates to new programs, affects reimbursement significantly, and as you have a limited number of years to build your FTE cap when a program is started. And once a cap has been set, it is extremely difficult– or certain circumstances must occur in order to get reimbursed for additional FTE slots in that program. But again, there’s going to be more on this in the webinar.
Kelly: Yeah, I bet there’s a lot there. You mentioned some component of IME and DGME. Will you be covering anything related to nursing allied health education?
Christina: That is another great question, Kelly. Actually, in 2023, Andrew Kinnaman, a manager here, did a great webinar specifically on nursing allied health education. But it does seem like it may be time for us to do another one on this topic. But that being said, I am going to cover it very briefly, but definitely not to the extent of the full webinar that we have available on our archives on our website. However, I will hit some of the highlights just for general education purposes because it is related to medical education.
Kelly: Wonderful. Well, thank you so much for joining us, Christina, and for sharing this sneak peek into the upcoming live webinar as part of BESLER’s Reimbursement Corner Series, Maximize the Accuracy of IME/GME, that you’re presenting live on Wednesday, February 12th, at 1 PM, Eastern Time. And as a bonus, you can earn CPE. Thanks again, Christina.
Christina: Thanks so much for having me. It’s always a pleasure, Kelly.
Kelly: Yes. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time…
[music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.com/podcasts. The Hospital Finance Podcast is a production of BESLER | SMART ABOUT REVENUE, TENACIOUS ABOUT RESULTS.
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