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A bipartisan bill introduced in Congress would establish a 5-year pilot to test four models aimed at educating and training primary care physicians in an effort to build up the PCP workforce.
A bipartisan bill introduced in Congress seeks to allow a portion of graduate medical education (GME) payments to go directly to community-based primary care residency programs, which in turn would collaborate with local hospitals to provide training in inpatient care.
The Primary Care Workforce Access Improvement Act of 2013, introduced by Reps. Cathy McMorris Rodgers (R-WA) and Mike Thompson (D-CA), would establish a 5-year pilot to test four models aimed at educating and training primary care physicians (PCPs). Those models include community entities working with two or more hospitals, two hospitals working together to develop a primary care program, a hospital subsidiary or independent corporation working with the community to further primary care, or a medical school or university collaborating with a hospital.
The current model for GME funding funnels Medicare GME dollars directly through hospitals but does not compensate the costs of training in non-hospitals, where American Academy of Family Physicians (AAFP) Board Chairman Glen Stream, MD, MBI, says primary care residents spend the majority of their training time. More than 90% of PCP care is delivered in the community, so primary care training should occur in community settings, Stream says. Because funding for physician training directly influences the type of physicians that are produced, Stream argues that the current system does not foster the production of PCPs.
"Discussions about reforming our health system frequently focus on better aligning payment to promote quality and efficiency," he adds. "GME funding and its effect on our physician workforce is very similar. This bill will align GME funding to promote production of the strong primary care workforce our country needs."
McMorris Rodgers adds that the bill will promote the training of PCPs in rural areas and test new and cost-neutral ways to distribute GME payments for the purpose of increasing the ranks of PCPs.
“As we continue to address the disparities in rural healthcare, one issue stands out: the shortage of [PCPs],” says McMorris Rodgers. “Our legislation encourages residents to train in rural areas like Eastern Washington. Once they complete residency, doctors usually stay in the area where they train, so our legislation is a vital first step to improving access to primary care in rural areas.”
The bill also mandates an Institute of Medicine (IOM) study to examine the effect of the pilot program on the quantity, quality, and distribution of PCPs compared with non-participants of the program.
“It’s time for us to reduce the challenges those in rural America face when it comes to accessing quality healthcare. This legislation gives physicians an incentive to practice medicine in rural communities-and as a result, it will be tremendously beneficial for the hospitals and residents in those areas. I look forward to joining my colleagues on both sides of the aisle to bring this legislation to a vote on the House floor,” McMorris Rodgers says.