– Researchers from the HRSA-funded Rural Residency Planning and Development Technical Assistance Center studied the effects of specific hospital classifications on Medicare GME payments. In this simulation study, the authors found that that median opportunity cost per resident was around $70,000 and $65,000 for SCHs and MDHs, respectively. This study demonstrates the significant financial barriers that SCHs and MDHs face in participating in GME program, under the current reimbursement method. The paper concludes that policy adjustments addressing the barrier may incentivize rural facilities to launch or participate in GME, which may help lessen the geographic maldistribution of physicians.