Press Release of Senator Cantwell

Cantwell Addresses Shortage of Primary Care to Reduce Health Care Costs and Improve Patient Care

Wednesday, May 27,2009

SEATTLE , WA  – As the Congressional debate about health care reform gains momentum,  U.S. Senator Maria Cantwell (D-WA) is working on two legislative initiatives to increase the number of practicing primary care doctors and remedy inefficient Medicare reimbursement rates.   During a press conference held today at the University of Washington Medical Center, Cantwell addressed how providing efficient, prevention-oriented care throughout the country, and ensuring primary care doctors are fairly compensated under Medicare, can produce better health care outcomes for patients and reduce costs overall.  The University of Washington School of Medicine has been ranked as the number one primary care medical school in the nation for 15 consecutive years by U.S. News and World Report.  Yet, due to the current structure of Medicaid, primary care doctors in Washington state aren't reimbursed fairly because they focus on providing high-quality efficient care, while Medicaid pays for quantity of services provided.  If every state in the United States could achieve the same kind of efficiencies seen in Washington, we could save close to $55 billion a year.

“Many of the conversations our state and nation  are having about health care reform focus on the uninsured, but when it comes to addressing the nation’s health care crisis and developing real solutions, the conversation can’t stop here,” said Cantwell.  “In Washington state, we should be proud of our health care system; we are efficient and our medical schools lead the nation in training primary care doctors.  But because of our efficiency, our physicians are also given less in Medicare reimbursements. Even though we are a leader in training the primary care physicians of tomorrow, many of these new doctors are choosing to practice elsewhere.   If we truly want to improve access to care for Washingtonians, while reducing costs for all,  we must  address how to improve access to care, how to increase the number of practicing  primary care physicians, and how best to protect patients’ relationships with their doctors.”

According to a report issued by the American College of Physicians, "primary care, the backbone of the nation's health care system, is at grave risk of collapse."  The College also predicts that the country will need 40 percent more primary care physicians by 2020.  In addition, detailed studies from the Center for Evaluative Clinical Sciences at Dartmouth and the Commonwealth Fund found that populations with ready access to primary care physicians realize improved health outcomes, reduced mortality, lower utilization of health care resources, and lower overall costs to care.

Cantwell plans to introduce two bills in coming weeks to address two of the fundamental problems that plague our nation’s health care system: a critical shortage of physicians and inefficient Medicare reimbursements that do not reward a coordinated approach of patients’ health care needs.  The legislation aims to provide efficient, cost-effective, prevention-oriented care throughout the country, especially in underserved and rural communities.

Specifically, the Preserving Access to Primary Care Act would help provide efficient, prevention-oriented care throughout the country.  It would also reward Medicare providers that offer well managed primary care and incentivize other providers to adopt better practices by:

• Establishing scholarships and loan forgiveness in exchange for primary care service commitments in critical shortage areas;
• Creating grants for medical school mentorship programs and primary care training in community health centers;
• Increasing Title VII and National Health Service Corps funding for primary care training;
• Removing caps on the number of residencies funded by the Medicare GME program with a preference for the new residencies given to primary care;
• Eliminating barriers to increased training in ambulatory care settings for primary care trainees; and,
• Enacting Medicare payment reforms to support the value of primary care in improving quality, coordinating care and reducing costs, and a transition to a new payment system based on the Patient Centered Medical Home.

The second bill, The Physician Workforce Enhancement Act, would improve access to health care by increasing the number of doctors trained in the specialties people need most, like family medicine, internal medicine, pediatrics, and behavioral and mental health by:

• Creating an interest-free loan program for hospitals committed to starting new residency programs in one of these in-demand specialties; and
• Providing financial assistance to hospitals to create residency programs in underserved rural areas.

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