FAQs

In 2019, HRSA commissioned a cost evaluation study to George Washington University to determine the actual cost associated with training a resident in a THC setting.  

 

They have determined the average cost to be a net of $209,623 per year per resident.  

 

This determination accounted for expenses and revenues highlighted below:

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EXPENSES

The expenses to train a resident in a Teaching Health Center (THC) can vary depending on several factors, including the location, specialty, program structure, and specific resources required for training. These costs can include:

• Stipends and Salaries: This includes the compensation provided to residents in the form of stipends or salaries for their training period.

• Benefits: Resident benefits such as health insurance, retirement plans, and other allowances.

• Educational Resources: Costs associated with educational materials, textbooks, software, and other learning resources.

• Licensing and Certification: Fees related to obtaining medical licenses, board examinations, and certifications.

• Faculty and Staff: Costs associated with the recruitment, salary, and benefits of faculty members, program directors, coordinators, and other staff involved in the training program.

• Administrative Costs: Expenses related to program administration, management, and compliance with regulatory requirements.

• Facility and Equipment: Costs associated with maintaining training facilities, including rent, utilities, equipment, and supplies.

• Accreditation and Compliance: Costs related to maintaining accreditation, fulfilling reporting requirements, and meeting compliance standards.

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REVENUE

Teaching Health Center (THC) programs can generate revenue from various sources to support their operations and the training of residents. The specific revenue streams can also vary depending on factors such as the program's location, affiliations, and funding mechanisms. Here are some common sources of revenue for THC programs:

• Medicaid Reimbursements: THCs often generate revenue through Medicaid reimbursements for the healthcare services they provide to Medicaid beneficiaries. As THCs typically operate in underserved areas, a significant portion of their patient population may be covered by Medicaid. Reimbursements from Medicaid can help offset some of the costs associated with patient care and support the financial sustainability of THC programs.

• Medicare Reimbursements: THCs can also receive reimbursements from Medicare for the services provided to Medicare beneficiaries. This includes payments for physician services, diagnostic tests, procedures, and other eligible services. Medicare reimbursements can contribute to the revenue stream of THC programs.

• Private Insurance Reimbursements: THCs that have agreements with private insurance providers can generate revenue through reimbursements for the healthcare services they deliver to patients covered by those insurance plans. Private insurance reimbursements can vary depending on the specific agreements and negotiated rates.

• Philanthropic Support: Some THC programs may receive financial support from philanthropic organizations, foundations, or community donations. These sources of revenue can provide additional funding to support program activities, infrastructure improvements, research initiatives, and community outreach efforts.

• State and Local Funding: In certain cases, THCs may receive financial support from state or local governments. This can include grants, subsidies, or other funding mechanisms that aim to promote healthcare access and address the needs of underserved populations within their jurisdictions.

• It's important to note that the revenue streams for THC programs can vary based on program-specific factors and local circumstances. Each THC program may have its unique combination of revenue sources tailored to its operational model and the specific needs of its community.  Keep in mind programs are not allowed to "double dip" or secure other GME funding such as CMS, or VA for residents claimed as HRSA THCGME residents.

 

Federal Funding is the primary source of revenue for THC programs provided through a grant. The Health Resources and Services Administration (HRSA) is the key federal agency that provides financial support to THCs through the Teaching Health Center Graduate Medical Education (THCGME) program. This funding helps cover the costs associated with resident training, stipends, salaries, faculty development, and program administration.

 

The Per Resident Allocation (PRA) provided by HRSA as of July 1, 2022 is $160,000 PRA, whereas the actual cost is $209,623 PRA leaving many programs with inadequate funding to operate their programs.

 

Please find the provided links below to access the COGME presentations on the Cost Evaluation Data.

 

Teaching Health Center Graduate Medical Education (THCGME) Cost Evaluation Update, Jennifer Trott, M.P.H., Senior Researcher

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Teaching Health Center Graduate Medical Education (THCGME) Cost evaluation Update, Marsha Regenstein, Ph.D., Professor, Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University