Opinion: Protecting health in Washington starts with supporting physicians
Health policy decisions that are made in Washington D.C. are felt in clinics and hospitals across Washington state and the country. Although lawmakers’ decisions directly affect the doctor-patient relationship, Congress frequently passes policies that shape our health system without direct input from physicians or patients.
This is why Washington’s physicians and the patients we serve are grateful for Rep. Kim Schrier, D-Wash. A pediatrician by training, Dr. Schrier is championing new legislation that would significantly improve our healthcare system.
At its heart, the Patients First Act (H.R. 9693) would help physicians nationwide who are struggling to expand patients’ access to high-quality care. Ultimately, the bipartisan bill would stabilize physician reimbursement and help practices weather the rising cost of care—costs that are contributing to physician shortages, fewer patient options, and higher out-of-pocket expenses for Washingtonians who have to travel farther for care.
Outdated Medicare payment policy is making these problems worse, especially in underserved communities and small towns across the state. The harsh reality is that Medicare physician reimbursement has fallen around 33% since 2001, even when adjusted for inflation. Moreover, certain technical provisions that result in annual cuts to Medicare physician payments have not been updated since the early 1990s.
When reimbursement for care doesn’t reflect increasing practice costs, physicians are forced to make compromises that affect patient access. Like any small business, medical practices face pressure to cut services and treatments, stop accepting new patients, or close their doors entirely when reimbursements fall significantly below costs.
For many Americans, their local physician is the only healthcare professional for miles. If these practices shut down, patients are forced to travel farther distances for appointments, leading many to delay or forgo important care.
The problem is especially serious in our state. Just 7% of Washington’s physicians and clinicians practice in rural communities, yet more than 4 million Washingtonians live in a Health Professional Shortage Area. With Washington having a significantly higher percentage of adults with poor or fair health compared to the national average, we can’t afford to continue with the status quo.
Patients living in underserved areas need change, and they need it now. Congress cannot sit back and allow Americans to lose access to physicians when there is a commonsense policy fix to modernize Medicare reimbursement rates and protect patient access to care.
And that’s just what Dr. Schrier’s legislation would do. If passed, the Patients First Act would create permanent, stabilizing fixes to Medicare payment policy, ensuring that the viability of independent healthcare practices is no longer under threat.
By linking annual payment updates to a measure of inflation, these reforms will ensure that rates remain stable and reflect the actual costs of practicing medicine. Raising the budget neutrality threshold for the first time since 1992 also would help improve payment accuracy and prevent unpredictable annual cuts. To further strengthen value-based care and address overly burdensome administrative requirements, the legislation would establish streamlined quality metrics and, for the first time, give physicians a seat at the table in developing these standards. Finally, it would encourage physicians to adopt promising innovations and strengthen care through alternative payment reforms.
Long-term, stable payment policy for independent physicians is long overdue. This bill is comprehensive, addressing issues that doctors have dealt with for decades. With dozens of cosponsors immediately after its introduction and the endorsement of numerous physician groups, it’s clear that the Patients First Act is the solution we need. Because when doctors can keep the lights on in their communities, patients win.
Washington’s physicians appreciate Dr. Schrier’s leadership on this issue and encourage the rest of Congress to follow suit and support passing this bill. Patients deserve a healthcare system in which access to care close to home isn't a luxury but a guarantee.