Federal bill would address primary care shortage

A House measure would establish loan and scholarship programs and increase Medicare payments for primary care practices.

By Chris Silva, amednews staff. Posted June 3, 2009.

Washington -- A Pennsylvania lawmaker has introduced a bill that she hopes will address a shortage of primary care physicians that could reach a catastrophic level within 15 years.

Rep. Allyson Schwartz (D, Pa.) introduced the Preserving Patient Access to Primary Care Act on May 20. The bill, which had over 100 co-sponsors as of late May, "takes a multifaceted approach to support our primary care work force and enhance care coordination services," Schwartz said.

According to the American College of Physicians, the nation could face a shortage of 45,000 primary care physicians or more by 2025. Additional research has shown that dwindling numbers of medical students plan to practice internal medicine.

To address these issues, Schwartz's bill calls for establishing grants to improve primary care mentorship programs. If approved, the measure also would create scholarships of up to $30,000 per year for students if they agree to complete a residency in family practice, internal medicine or pediatrics for a facility that has a physician shortage.

In addition, the legislation seeks to:

Provide loan forgiveness for physicians, nurses and nurse midwives who meet primary care obligations in shortage areas.
Give grants to states to incorporate the patient-centered medical home into Medicaid and the Children's Health Insurance Program.
Direct Medicare to pay for care coordination services on a fee-for-service basis that have been shown to improve outcomes for patients with chronic illnesses.
Increase graduate medical education residency caps.

Several medical organizations support the bill, including the ACP, the American Academy of Family Physicians, the American Academy of Pediatrics, the Assn. of American Medical Colleges, the National Physicians Alliance, the American Osteopathic Assn., the American Nurses Assn. and the American Academy of Nurse Practitioners.

Sen. Maria Cantwell (D, Wash.) is expected to introduce companion legislation after Congress returns from its Memorial Day recess.

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