Children's Hospitals Graduate Medical Education
Payment Program > 2006 Performance Measures

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I.A.1.  Maintain the number of FTE residents in training in eligible teaching hospitals. 

The total number of full‑time equivalent (FTE) residents being trained on-site and off-site in FY 05 was reported at 5,103, an increase of 211 FTE residents from the 4,892 FTE residents reported in FY 04.  The data captures the number of residents training in hospitals, those rotating through the hospital for training, and those rotating outside the hospitals.

Long-Term Goals

Percent of participating hospitals with verified FTE resident counts and caps.

Percent of hospitals with verified bed counts, case-mix index, and number of discharges.

(This measure is contingent upon the results of pilot studies.)

VII.C.1.  Percent of participating hospitals with verified FTE resident counts and caps.

In FY 03, the CHGME PP implemented a comprehensive assessment of all FTE resident counts provided by each of the children’s hospitals on their initial application for CHGME payments, including assessment of the FTE resident caps.  The program’s target was to assess 100 percent of the hospitals’ FTE resident counts used in the determination of CHGME payments.  The CHGME PP achieved that target.  The program has consistently achieved this target every year. 

Also, the CHGME PP as part of its own self-evaluation process developed documentation guidance for use by children’s hospitals to assist them with compliance requirements, and to continue promoting consistency, equity and timeliness of the assessments for all children’s hospitals in future years.  Other assessment process efficiencies are being implemented to reduce both hospital burden and costs associated with these assessments.  All of the FTE resident counts claimed by children’s hospitals for purposes of payment will be assessed prior to the final determination of payments each fiscal year that funds are disbursed.

VII.C.2.  Actions to assess the feasibility and cost-effectiveness of verifying hospitals bed counts, case-mix indices (CMI), and number of discharges.

The bed counts, case mix index, and number of discharges affect the determination of IME payments.  The objective is to assess whether it is cost-beneficial to conduct a comprehensive assessment of these reported measures for all children’s hospitals participating in the program each fiscal year .  In FY 04, CHGME PP completed the development of protocols describing proposed assessment methodologies previously targeted for FY 05.  In FY 05 the program completed the pilot study for assessing bed counts, and in FY 06 the program completed the pilot study evaluating hospitals’ case-mix indices and respective number of discharges.  In both instances (auditing beds and auditing number of discharges and respective case-mix index), recommendations have been completed for consideration. 

Percent of payments made on time.

The efficiency measure for this program is to make 100 percent of DME and IME payments to children’s hospitals on time.  The payment process is mandated by law and requires (1) determination of two interim payments, DME and IME, based on children’s hospitals initial application for funds before the beginning of each fiscal year; (2) monthly payments to start with the beginning of each fiscal year, dependent on availability of funds; and (3) two reconciliation payments, DME and IME, to be disbursed on a monthly schedule, that are dependent on the Secretary’s final determination of the number of FTE residents training at these institutions.  For FY 06, 100 percent of DME and IME payments to children’s hospitals were made on time.  The CHGME PP is utilizing both efficient management practices and electronic capabilities to generate its payments on time.