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JAMA. 1999;281:2156.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Because graduate medical education (GME) funding is being discussed as part of the effort to reform Medicare, the AMA Resident and Fellow Section (RFS) is working to educate residents on how that funding currently operates. The May 26 Resident Physician Forum explained the method used by the Health Care Financing Administration to calculate direct payments from the Medicare program to hospitals for GME. We now provide an overview of the method used to calculate the Indirect Medical Education Adjustment (IMEA).

The IMEA compensates teaching hospitals for higher operating costs associated with the presence of a residency program, costs incurred by having more complicated cases, additional tests ordered by residents in their learning process, and reduced patient care productivity by all staff members. The formulas for IMEA are based on statistical estimates since indirect costs cannot be accurately quantified. For example, it is difficult to quantify how much patient care productivity . . . [Full Text of this Article]

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