Medical Education and Research Costs (MERC) 1998 Trust Fund Distribution
The MERC Trust Fund was established in 1996 to provide funding for the clinical training of selected medical professions. The purpose of this funding is to compensate teaching facilities for a portion of the costs of clinical training provided in a patient care setting. These are costs that have traditionally been covered by teaching facilities charging higher rates for patient care, a strategy that is becoming more and more difficult as competition increases.
The MERC Trust Fund was established in 1996 and funded in 1997, with $5 million from the General Fund and $3.5 million from the Health Care Access Fund. In addition, $9.26 million in Federal matching funds have been approved by HCFA, bringing the total Trust Fund for 1998 distribution to $17.76 million.
Provider types included in the MERC Trust Fund
-
Advanced Practice Nurses
-
Dental Students
-
Dental Residents
-
Medical Students
-
Medical Residents
-
PharmD Students
-
PharmD Residents
-
Physician Assistants
| $8,500,000 General Access Fund
$9,260,133 Federal Match |
|---|
| $17,760,133 Total 1998 Trust Fund |
Applications for the 1998 MERC Trust Fund were due in November, 1997. The Trust Fund received 16 applications on behalf of 154 teaching programs, representing over 300 sites of training and 2,710 trainees. Applications are submitted by Sponsoring Institutions, the organizations that are organizationally and/or financially responsible for one or more teaching programs. Funds will be disbursed to the sponsoring institutions, with explicit requirements to pass the funds through to the training sites where clinical training takes place. Many entities in Minnesota are both sponsoring institutions and training sites. Many hospitals and clinics are training sites for several different teaching programs.
The 1998 MERC Trust Fund is distributed based on a formula which reflects the number of eligible FTEs at a particular site as well as the statewide average cost of clinical training for that provider type. The Trust Fund reimburses a uniform percentage of clinical training costs for each of the 8 provider types. For the 1998 Trust Fund, this percentage is 5.9%. The annual average clinical training costs per trainee vary significantly across the 8 provider types (See table below, data from MERC applications, based on audited financial data from fiscal 1996.)
Provider Type |
Number of Programs |
Eligible FTEs |
Average Cost Per Trainee* |
Adjusted Total Costs** |
% of Trust Fund |
Grant Amount |
Grant per Trainee |
% of Costs Covered |
| Advanced Practice Nurses | 11 |
165.0700 |
$20,537 |
$3,390,043 |
1.1255% |
$199,899 |
$1,211 |
5.90% |
| Dental Students | 1 |
107.2100 |
$105,788 |
$11,341,531 |
3.7656% |
$668,771 |
$6,238 |
5.90% |
| Dental Residents | 12 |
76.0400 |
$136,052 |
$10,345,394 |
3.4348% |
$610,032 |
$8,023 |
5.90% |
| Medical Students | 5 |
513.3031 |
$23,489 |
$12,056,977 |
4.0031% |
$710,958 |
$1,385 |
5.90% |
| Medical Residents | 117 |
1,783.6124 |
$146,765 |
$261,771,874 |
86.9125% |
$15,435,778 |
$8,654 |
5.90% |
| PharmD Students | 1 |
28.9000 |
$22,093 |
$638,488 |
0.2120% |
$37,649 |
$1,303 |
5.90% |
| PharmD Residents | 6 |
16.2500 |
$60,796 |
$987,935 |
0.3280% |
$58,255 |
$3,585 |
5.90% |
| Physician Assistants | 1 |
20.3750 |
$32,287 |
$657,848 |
0.2184% |
$38,791 |
$1,904 |
5.90% |
| Total | 154 |
2,710.7605 |
$111,109 |
$301,190,089 |
100% |
$17,760,133 |
$6,552 |
5.90% |
*Average Cost per Trainee was calculated by taking the Total Clinical Costs for all programs of a particular provider type and dividing this total by the Total FTEs for that provider type.
**Adjusted Total Costs is calculated by taking the Average Cost per Trainee times the number of eligible FTEs.
Metro / Non-Metro
Applications and Disbursements for the 1998 MERC Trust Fund
Sponsoring Institution |
City |
Teaching Programs |
Eligible FTEs |
| Abbott Northwestern Hospital | Minneapolis |
2 |
32.0000 |
| Allina Health System/United Hospital | Minneapolis |
1 |
17.0300 |
| Augsburg College | Minneapolis |
1 |
20.3750 |
| College of St. Catherine | St. Paul |
1 |
13.2500 |
| College of St. Scholastica | Duluth |
2 |
15.3000 |
| Duluth Medical Education Council | Duluth |
1 |
29.0000 |
| Hennepin County Medical Center | Minneapolis |
11 |
192.9100 |
| Mankato State Univ. School of Nursing | Mankato |
1 |
15.9150 |
| Mayo Foundation | Rochester |
64 |
919.4284 |
| Minneapolis Sports Medicine Center | Minneapolis |
1 |
1.6000 |
| Regions Hospital | St. Paul |
6 |
62.8900 |
| St. Mary's Hospital Univ. of Minnesota | Minneapolis |
1 |
38.0000 |
| United Hospital and Children's Healthcare | St. Paul |
2 |
3.2500 |
| Univ. of MN Academic Health Center | Minneapolis |
57 |
1,323.4871 |
| Winona State University | Winona |
2 |
18.3500 |
| Women's Healthcare Nurse Prac. Program | St. Paul |
1 |
7.9750 |
| TOTAL | 154 |
2,710.7605 |
The above sponsoring institutions have applied on behalf of the teaching programs they administer and the training sites used by these teaching programs. As required by the MERC statute, the applications report for each teaching program: costs of clinical training, revenues associated with medical education, information on accreditation, and information on the training sites used by the teaching program, and the number of Full Time Equivalents (FTEs) trained at each training site. Funding from the MERC Trust Fund is directed to the Sponsoring Institutions, with specific requirements that these funds be forwarded to the actual training sites.
Applications are coordinated by, and funding directed to, the Sponsoring Institutions, rather than the training sites, to preserve the integrity of the teaching programs, and so that accurate and complete information about medical education teaching programs can be obtained.
The MERC Trust Fund dollars will flow from the Trust Fund through the Sponsoring Institutions to the training sites. The table below reports information on how much of the MERC Trust Fund will be received by the training sites used for medical education in Minnesota. As mentioned above, many of these hospitals and clinics are training sites for numerous teaching programs, and for this table, we have summed the grant amounts each site will receive from each of the teaching programs they participate in, so that their total revenue from MERC is reflected.
Training Site |
City |
Number of Eligible Trainees |
Percent of |
Grant Amount |
| St. Mary's Hospital | Rochester |
384.69 |
16.86% |
$2,994,574 |
| Mayo Clinic | Rochester |
370.27 |
16.27% |
$2,890,271 |
| Hennepin County Medical Center | Minneapolis |
375.89 |
13.87% |
$2,463,066 |
| Fairview University Medical Center | Minneapolis |
308.33 |
11.42% |
$2,027,792 |
| Regions Hospital | St. Paul |
207.43 |
7.61% |
$1,350,994 |
| Rochester Methodist Hospital | Rochester |
156.78 |
7.00% |
$1,243,215 |
| U of MN Dental School Clinic | Minneapolis |
156.03 |
5.97% |
$1,060,430 |
| Fairview Riverside Hospital | Minneapolis |
83.88 |
3.75% |
$665,495 |
| Abbott Northwestern Hospital | Minneapolis |
74.90 |
2.12% |
$376,657 |
| North Memorial Medical Center | Robbinsdale |
39.08 |
1.47% |
$261,705 |
| Children's Healthcare St. Paul | St. Paul |
43.21 |
1.40% |
$248,168 |
| University of Minnesota Surgery | Minneapolis |
22.00 |
1.07% |
$190,393 |
| St. Joseph's | St. Paul |
19.63 |
0.87% |
$155,344 |
| Children's Health Care Minneapolis | Minneapolis |
28.33 |
0.77% |
$137,424 |
| St. Joseph's | St. Paul |
19.63 |
0.87% |
$155,344 |
| Health System MN | St. Louis Park |
14.88 |
0.73% |
$128,775 |
| Mayo Psychiatry and Psychology Treatment Center | Rochester |
14.90 |
0.64% |
$114,410 |
| St. Luke's Hospital of Duluth | Duluth |
14.06 |
0.61% |
$109,000 |
| United Hospital | St. Paul |
13.14 |
0.60% |
$106,113 |
St. Mary's Medical Center |
Duluth |
12.25 |
0.53% |
$93,425 |
St. John's Hospital HealthEast |
Maplewood |
11.01 |
0.41% |
$73,476 |
University Affiliated Family Physicians |
St. Paul |
8.42 |
0.41% |
$72,869 |
| HealthPartners | Bloomington |
19.92 |
0.40% |
$70,185 |
Duluth Family Practice Center |
Duluth |
16.95 |
0.38% |
$66,728 |
Methodist Hospital |
St. Louis Park |
13.34 |
0.37% |
$66,096 |
| Gillette Children's Hospital | St. Paul |
6.65 |
0.27% |
$47,200 |
Duluth Clinic |
Duluth |
32.37 |
0.25% |
$44,500 |
| Rural Physician Center | Minneapolis |
23.00 |
0.18% |
$31,856 |
| Park Nicollet Clinic | Minneapolis | 9.02 |
0.15% |
$25,810 |
| St. Cloud Hospital | St. Cloud |
3.29 |
0.14% |
$25,518 |
| Community-University HealthCare Center | Bloomington |
4.79 |
0.14% |
$24,732 |
| Mankato Clinic | Mankato |
4.49 |
0.12% |
$21,812 |
| University of MN Lab & Pathology | Minneapolis |
2.46 |
0.12% |
$21,289 |
| Park Nicollet Hand Center | St. Louis Park |
2.00 |
0.10% |
$17,308 |
| Institute for Research and Education | Minneapolis |
2.00 |
0.10% |
$17,308 |
| Family Practice Center | St. Cloud |
1.88 |
0.09% |
$15,466 |
Unity Hospital |
Fridley |
2.59 |
0.08% |
$14,971 |
| Waseca Area Medical Center | Waseca |
1.93 |
0.08% |
$13,431 |
| Duluth Ob/Gyn Assoc. | Duluth |
9.19 |
0.07% |
$12,734 |
| Colon and Rectal Surgery Assoc. | St. Paul |
1.19 |
0.06% |
$10,299 |
| Other Clinics - Combined | 163.68 |
2.20% |
$391,518 |
|
| Other Hospitals - Combined | 30.92 |
0.33% |
$57,774 |
|
| Total | 2,710.76 |
100.00% |
$17,760,133 |
