1. GME Value Model Sri Koduri MS, MPA Brad Poss MD, MMM

2.  What is the charge?  Gather and analyze data (show residents and fellows separately)  Assemble info on residents and fellows and how they are paid (include length of programs)  Make sure data is right - chair and administrator should sign off on their lines  Need consistent way to maintain data  How should we define a fellow?  How much DME & IME does UH receive?  Need to count everybody, including research years?  Propose recommendations for management of GME processes and potential cut GME W ORKGROUP : C HARGE & C ONSIDERATIONS  For Consideration  Workforce needs - training our competition  Areas of excellence - reputation & influence  Critical mass for program administration/experience  Less expensive labor mentality?  How would we sustain a significant cut? (eg, 20% DME and 100% IME)  Mechanism for controlling growth

3. GME W ORK G ROUP : M EMBERS  Brad Poss (Chair)  Sri Koduri (Co-Chair)  David Browdy  Bruce Herman  Tom Miller  Caroline Milne  Catalina Ochoa  Wayne Samuelson  Barb Viskochil  Sharee Bracken (ad hoc)  Alan Smith (ad hoc)

4. P ROCESS SoM EC Charge & Workgroup Creation Demographic and Fiscal Information Collection Value Model & Stress Test Development Feedback from GME CommitteeValue Model and Stress Test Pilot for Pediatrics Final Report out to SoM EC and Charge to Go Ahead with Program and Department Buy-in

5. #1 D EMOGRAPHICS AND F ISCAL D ATA –Number of programs, residents and fellows Accredited vs. Non Accredited –Retention by program – U of U, Utah, Region Are we training our competition? –Break down of fiscal support Hosp. vs. Dept. vs. Affiliated Funding per program DME & IME GME Office & Other Administrative Budget

6. GME F ISCAL I NFORMATION GME Funding (2014 Data) DME Cap307.29 IME Cap279.50 Total GME Funding$35,067,458 DME Funding$6,959,898 IME Funding$23,495,285 Medicaid DME Funding$4,612,275 GME Expenditures GME Office Budget$1,750,629 GME Staff Salary/Benefits$874,482 Operating Expenses$876,147

7. GME R ESIDENT I NFORMATION ResidentsFellowsTotal $MFTE$MFTE$MFTE$ %FTE % U Hospital21.7284.331.519.3323.1303.664140 Departments1.722.788.8112.4910.4135.2718 Affiliates17.6241.293.748.5921.3289.8838 Grants0.48.790.68.72117.5122 Military0.23 2.080.45.0811 Saudi Arabia0.4600 611 Totals$41.9566.19$14.7191.21$56.6757.4100

8. #2 C ONCEPT OF GME V ALUE Is the GME program(s) aligned with the institutional mission and vision? What value does GME training add to the UUHS? How to optimize the GME program and spending? If resources were threatened, what are some areas that can be cut back while retaining value of the program?

9. #2 V ALUE M ODEL : C OMPONENTS AND T OOLS 1.Education 2.Research Impact 3.HSC Mission 4.Retention 5.Program level impact on Health System Finance 6.Bonus category 7.Future metrics (not scored) Questionnaire that addresses each component below with mixture of pre- filled data and request for program/department responses

10. #3 S TRESS T EST : C ONCEPT Three potential goals of a stress test –Department analysis on how they would manage certain levels of cut educationally including clinical service effect –Larger HSC global analysis of how cuts would be prioritized across departments. –Identify and communicate system-wide priorities when resources are constrained Structure of stress test –Simple questions and essay response in conjunction with value model Implementation of the value model/stress test

11. #3 S TRESS T EST : F ORMAT Respond to a potential 20% GME funding cut: –For Programs: Potential reduction Alternative sources of funding System wide areas of consolidation –For HSC leadership: How could a stratified program budget resizing plan be made based on the GME Value Model? Value model and stress test results can help align programs with HSC mission, vision and goals and vice versa.

12. GME V ALUE P ROJECT W ITH V ALUE M ODEL, S TRESS T EST AND UUHS P ARTICIPATION Value Model Each program assessed based on 5 basic criteria and a bonus criteria Relative performance helps determine Programs’ alignment with UUHS mission and identifies gaps Stress Test Programs will complete stress test based on program costs, budgeting processes, and priorities suggest approaches to potential funding cuts identify potential alternative funding sources and administrative models UUHS UUHS will use this information to: Understand GME priorities Establish criteria for cuts and consolidation Come up with alternative models and finalize areas of cuts Communicate values and priorities with programs based on where they are now and where they need to be

13. P ROGRAM B UY -I N & F EEDBACK WITH T OOLS How do program directors/chairs value their programs? –Value Model Questionnaire and Rubric What is their opinion on budget cut management and optimization? –Stress test How to prepare programs for potential budget cuts? –UUHS exercise based on value model and stress test

14. Q UESTIONS & D ISCUSSION