A family medicine residency program at St. Luke’s Hospital will end and transfer back to its original home at the University of Toledo Medical Center because of a dispute with a federal agency over funding.
The Centers for Medicare and Medicaid Services informed ProMedica recently that the residency program is a transferred program, not a new residency program, and thus ineligible for the reimbursements it had been receiving. The hospital system received Indirect Medical Education and Direct Graduate Medical Education payments for the program, but CMS determined it was not actually eligible for those funds, CMS spokesman Elizabeth Schinderle said.
There was a “proposed adjustment,” but CMS would not comment on how much money it claims ProMedica owes because the amount hasn’t been finalized.
ProMedica has decided to end the program at St. Luke’s because of CMS’ decision, but UTMC, the former Medical College of Ohio, will step in and serve as a sponsor, university officials said.
“We had the option to let it close, but that is not the right thing to do,” said Dr. Ronald McGinnis, interim dean of UT’s college of medicine and life sciences.
A ProMedica spokesman said the hospital system is appealing the CMS decision, and said that the appeal process could take between three and four years.
“Meanwhile, ProMedica is working closely with University of Toledo Medical Center to ensure that program is transitioned back to UTMC and the quality of care is maintained,” the spokesman said.
Indirect Medical Education payments are extra funds given to medical facilities because of the higher relative cost of care at teaching hospitals. Direct Graduate Medical Education payments are funds to defer the cost of residency programs.
The residency program has been St. Luke’s since 2007, when the hospital assumed sponsorship from UTMC, which started the program in 1977. Residents spend three years at the hospital, working with St. Luke’s staff and being trained by UTMC faculty. The program admits four residents a year.
Resident physicians have graduated medical school but do not yet have board certification. Residency programs must be sponsored by a hospital.
The university will take control of the program July 1, UT's Executive Vice President of Finance and Administration David Morlock told board of trustees members earlier this month. Residents will stay at St. Luke’s for the first year, and ProMedica will cover the program’s cost during that time. On July 1 of next year, the program will move into a yet-to-be-determined UTMC facility.
Mr. Morlock, who also serves as UTMC chief executive officer, said the former U.S. Department of Veterans Affairs building on Glendale near UTMC could be a potential home for the program. Renovations to the building would cost an estimated $3.5 million, and take nine to 12 months to complete, he said.
The residency program would cost about $1.4 million annually to run, though Mr. Morlock said that expense would likely be offset by revenue generated by the residents.
While there’s a cost to bring the program back to UTMC, Mr. Morlock said officials believe it’s important to keep a family medicine residency in Toledo.
“We don’t believe that’s in the best interests of the community,” Mr. Morlock said of letting the program end.
Without the residents, there would be less capacity to handle family medicine in the city, he said, and there’s an expected shortage of family medical physicians in upcoming years.
Residency programs can serve as a doctor pipeline in a community, with physicians opening a practice or joining a hospital system after their residency ends.