Total Medicaid funds invested in graduate medical education (GME) increased from $3.78 billion in 2009 to $7.39 billion in 2022. States have considerable flexibility in designing Medicaid GME payments to address population health needs.

This article assesses states’ inclination for using Medicaid funds for GME, the structure of state Medicaid payments, the composition and charge of advisory bodies that guide these investments, and the degree of transparency and accountability to track whether Medicaid GME investments achieved desired workforce outcomes.