This document represents AACOM’s Public Policy Agenda for the 116th Congress. It reflects the association’s federal advocacy priorities to ensure that osteopathic medical education (OME) is an active force in the formulation of national health and higher education policies. AACOM will aggressively pursue these goals, notwithstanding the challenging political and fiscal environment, as osteopathic medical schools continue to grow in number, size, and importance to the U.S. health care and medical education systems.
Graduate Medical Education
AACOM strongly supports programs that promote medical education, particularly innovative programs designed to better prepare physicians to provide high quality care to patients and improve the health of communities in the 21st century. Federal graduate medical education (GME) funding is critical to ensure the stability and continuity of both the nation’s medical residency training programs that produce future physicians and the health care system that provides care to our nation.
AACOM’s GME policy priorities include:
- Preserving Medicare GME funding, as any cuts to GME will ultimately increase, not decrease, health care costs;
- Lifting the statutory cap on Medicare-funded GME slots;
- Exploring additional methods of financing GME outside of the Centers for Medicare & Medicaid Services, particularly in underserved rural and urban areas;
- Continuing and providing sustainable funding for the Health Resources and Services Administration (HRSA)’s Teaching Health Center GME Program, which addresses the nation’s primary care workforce shortage by increasing physician training and retention in primary care;
- Supporting programs that expand community-based GME to meet the nation’s evolving health care needs;
- Associating GME funding directly with workforce needs to meet the health care needs of a growing, aging, and diverse population;
- Informing and collaborating with policymakers and partnering with other key stakeholders to address the challenges of reassessing the GME system, while simultaneously recognizing the need for GME funding accountability;
- Facilitating OME participation in the expansion and sustainment of GME positions at the U.S. Department of Veterans Affairs (VA) medical facilities; and
- Working with the Medicare Payment Advisory Commission, the Council on Graduate Medical Education (COGME), and other federal committees to support a physician workforce that meets the needs of diverse patient populations in an evolving health care system.
AACOM advances federal health care workforce policies intended to support an adequately trained physician workforce to meet patients’ health care needs in the 21st century.
AACOM’s physician workforce policy priorities include:
- Reauthorizing and sustainably funding HRSA’s Title VII health professions education and workforce training programs, which are beneficial and cost-effective and have been vital to the growth of OME and primary care training;
- Consistently funding and investing in federal scholarship and loan repayment programs, such as the National Health Service Corps and the Indian Health Service, which recruit and retain physicians and other health care professionals—particularly those in primary care—in medically underserved areas and areas most impacted by national epidemics;
- Aligning the physician and broader health professional workforce to care for the nation’s patient populations, as advanced by the work of federal committees such as COGME, HRSA’s Advisory Committee on Training in Primary Care Medicine and Dentistry, the VA’s National Academic Affiliations Council, and other bodies;
- Securing opportunities to maximize engagement of OME through the implementation of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, the law addressing the opioid epidemic; and
- Targeting health care workforce data production, analysis, and oversight to ensure that investments in the future of health care appropriately address the geographical areas of greatest need.
Medical Students and Federal Student Financial Aid
AACOM recognizes the significant student loan debt burden osteopathic medical students and graduates shoulder, as well as the overall impact this has on students pursuing primary care and other critical specialties. In the 2018-19 academic year, osteopathic medical schools are educating nearly 31,000 U.S. medical students—25% percent of all U.S. medical students. As osteopathic medical student debt rises, addressing accruing interest on federal loans, which considerably inflates the overall cost of medical student debt, must be addressed. Many of these students are also entering medical school with high debt from their undergraduate education, further exacerbating their loan debt after graduation.
AACOM’s medical student and federal student financial aid policy priorities include:
- Reauthorizing the Higher Education Act (HEA) and maintaining and protecting the Public Service Loan Forgiveness and Grad PLUS Loan Programs;
- Employing AACOM’s ED to MED campaign to protect federal financial aid programs in the HEA reauthorization to help prospective and current medical students finance their education;
- Urging Congress to explore fiscally responsible solutions to lower medical student debt through lowering interest rates and interest rate caps for graduate and professional students;
- Investing in new programs and continuing to support existing programs that directly fund students pursuing primary care and other needed specialties;
- Reinstating the in-school interest subsidy for graduate students on Federal Stafford Loans;
- Addressing statutes and regulations that increase the administrative and financial burdens that interfere with the educational mission of member institutions, such as state authorization and gainful employment regulations; and
- Requiring foreign medical schools to meet the same standards and accountability as U.S. medical schools to qualify to receive Title IV federal financial aid.
As osteopathic medical schools continue to grow and educate increasing numbers of students across the country, AACOM supports fully integrating osteopathic medicine into the nation’s federal research infrastructure.
AACOM’s research policy priorities include:
- Increasing funding for the Agency for Healthcare Research and Quality (AHRQ) to include promoting evidence-based data to address the opioid epidemic and expanding AHRQ programs that evaluate quality of care, promote knowledge transfer, and fund patient-centered outcomes research (PCOR);
- Investing in and increasing funding for the National Institutes of Health (NIH) to include loan repayment programs that recruit and retain health professionals pursuing research careers;
- Investing in NIH’s National Center for Complementary and Integrative Health to expand a full spectrum of research on osteopathic manipulative medicine, from basic to applied research to investigate and assess its efficacy;
- Continuing funding for PCOR implemented by the Patient-Centered Outcomes Research Institute (PCORI) and assuring osteopathic researcher training eligibility within PCORI; and
- Funding research by the Center for Medicare & Medicaid Innovation, AHRQ, and other agencies to explore innovation in physician training models and health care delivery.
AACOM continues to advocate for osteopathic medical educators and physicians to serve on federal committees and advisory boards.
AACOM’s osteopathic representation policy priorities include:
- Nominating osteopathic medical educators and osteopathic physician experts for federal committees, commissions, councils, advisory panels, and task forces—collaborating with the American Osteopathic Association and other national associations to strategically increase osteopathic representation on these federal bodies;
- Elevating visibility of OME and informing Congress and federal agencies about the importance of representation from this medical community; and
- Collaborating with and providing recommendations to federal agencies, including the U.S. Departments of Education, Health and Human Services, and the VA to ensure OME is an active force in the formulation of federal policies, negotiated rulemaking, and report recommendations to agencies and Congress.