(11-18-2020 07:05 PM)georgewebb Wrote:  

(11-18-2020 12:34 PM)ruowls Wrote:  That is the main issue with residents. They are paid employees that don't generate revenue on their own. The encounter is billed by the attending physician through the program. It is not an efficient system to capture charges for services provided.

Honest question: if the residents work is being billed, and their salaries are low, it seems like they should be net money makers for the hospital. Does a lot of their work not billable at all? Or is it billable but (for some reason) doesn't actually get billed? Or is there something I else I don't know (perhaps a great deal!)?

Good question. And it goes to the heart of the Byzantine character of graduate medical education. As ruowls said, the residents can’t bill while they are in a training program. The work that they do is billed under the physician faculty member who is supervising them. Often times the program that is sponsoring the residency provides care for indigent and/or under-funded patients. So, it’s not uncommon for the collections from resident supervised care to be in the 10-30% range, or less. And in many programs, those collections go to support the supervising faculty salaries, as well as adiministrative costs (lots), insurance..medical and malpractice, didactic educational expenses, travel to other educational activities, etc. If the residency program is federally funded, that federal money goes a fair way to support resident salaries, but that’s about it. Collections from patient care will not make up the rest of the cost of running the programs. Not by a long shot.