House Legislation Lays Groundwork for Primary Care Base

The House is considering a bill that would reform the nation's Medicare system by financially encouraging students to enter primary care while also bolstering payments for current primary care physicians and the patient-centered medical home, or PCMH.

Rep. Allyson Schwartz, D-Pa., a member of the House Ways and Means Committee, introduced H.R. 7192 on Sept. 27. The bill, known as the Preserving Patient Access to Primary Care Act, would establish grants, scholarships and loan forgiveness programs to encourage medical students to choose careers in primary care.

It also would provide enhanced monthly fees for physician practices that operate as qualified PCMHs. At the same time, the bill would establish higher payments for primary care providers and provide payment for services such as telephone and e-mail consultations. In addition, the bill would require a study to recommend the designation of primary care as a shortage profession if certain criteria are met.

Although the current Congress will not have time to pass the bill, the bill's language lays the foundation for health care reform efforts during the next Congress, and it serves as a way to include primary care services in any major health care reform legislation next year, said Kate Gross, legislative aide to Schwartz. Sen. Maria Cantwell, D-Wash., is expected introduce a companion bill in the Senate next year, according to Gross.

"(The bill) is really designed to make sure that there is a comprehensive piece of legislation out there that helps to shore up our base of primary care providers," said Gross.

She described Medicare's current costs as "unsustainable," saying that H.R. 7192 attempts to increase the overall quality of care in Medicare and best use limited health care resources by promoting primary care services. The bill's overriding goals are twofold: to increase the provision of primary care services under Medicare and to encourage physicians to pursue a career in primary care through financial incentives and loan forgiveness programs.

"A lot of young medical students are not necessarily feeling the incentive to go into primary care," said Gross. "They are not paid well, their hours are not ideal and they have a harder time repaying their loans."

Gross described Schwartz as a strong proponent of primary care, explaining that the congresswoman believes in "providing the right care, at the right time, with the right provider."

"That starts with having a home base," Gross said. "That is where her support of the medical home comes in. Rep. Schwartz sees the medical home as an opportunity to help patients get a better understanding of what is going on with their health, to understand what their next steps might be and also having someone who is there helping to coordinate their care," said Gross. "Otherwise, they get left out in the cold."