A letter sent by the American College of Physicians (ACP) to key legislators has urged them to ensure that the final health care reform bill includes provisions to support the primary care workforce.
"Recent studies show that the U.S. faces a shortage of more than 40,000 primary care physicians, even before taking into account increased demand for primary care associated with increased coverage," said ACP President Joseph W. Stubbs, MD, FACP in the letter.
The letter noted that legislation needed to ensure that there would be enough primary care provisions to provide adequate access to care for the more than 30 million additional Americans who may soon have affordable coverage, as well as those who already have coverage. Specifically, ACP requested that the final bill:
- Increase Medicaid and Medicare payments to primary care physicians. Studies show that low levels of reimbursement for primary care, especially relative to other specialties, is a principal reason why physicians are not going into primary care. Under both bills, Medicaid will be expanded to cover millions of more Americans, but many of them will not be able to find a primary care doctor if low payment rates continue to make it impossible for primary care doctors to accept more Medicaid patients. ACP urged support for a provision in the House bill to increase Medicaid payments to equal the Medicare rates within four years. Both bills have provisions to increase Medicare primary care payments. ACP recommended that the final agreement incorporate the Senate's 10 percent primary care bonus, but apply it more broadly to primary care services and physicians as proposed by the House, many of whom would be excluded under the Senate's more restrictive language.
- Expand pilot testing and implementation Patient-Centered Medical Homes (PCMHs). Both bills have provisions to expand testing and implementation of medical home in both Medicare and Medicaid, but only the House has specific funding for two Medicare medical home pilots.
- Increase support for primary care training programs, including providing mandatory increased funding for the National Health Service Corps and Title VII primary care training programs.
A one-page summary of the key primary care programs from both the House and Senate bills that should be included in a final agreement also was provided. [Editors - please contact ACP for the summary.]
"Throughout this debate," Dr. Stubbs concluded, "ACP has been steadfast in standing with you for reforms to provide all Americans with access to affordable health care and to a primary care physician of their choice. We look forward to helping you complete your work on sending a bill to President Obama that advances these essential shared goals."