Medicare spends $9 billion a year paying for the medical residencies where doctors get their clinical training. That training needs to change as part of the nation’s big health-reform push, argued a report out yesterday from MedPAC, the commission that advises Congress on Medicare. The report looked broadly at health-system reform, touching on a number of issues we’ve been hearing a lot about lately — the way Medicare pays doctors for volume rather than quality, for example, and how private insurers in the Medicare Advantage program are paid more than traditional Medicare programs. more.