Dr. Clint Hauxwell: Medicare cuts threaten Washington physicians, patient access

By Clinton Hauxwell, M.D.

The COVID-19 pandemic has increased the financial strain on physician practices here in Washington and nationwide. Staffing remains a critical issue as many nurses, medical assistants, and other support personnel have left the medical field for higher paying jobs in other sectors. Many group practices have been forced to reduce services because of staffing shortages. Furthermore, rising inflation has dramatically impacted the cost of supplies and equipment that are critical to providing quality medical care.

Yet, even as the medical and health care community begins to recover from the increased pressures of the past two-and-a-half years, longstanding problems within the Medicare physician payment system threaten physicians with steep cuts that could adversely impact access to care for the patients we serve.

A recent analysis of Medicare data reveals that physician payments through the program plummeted 22% in the 20-year period from 2001 to 2021 when one adjusts for inflation. Moreover, because of a federal statute put in place by Congress, physicians are the only types of Medicare providers who will not receive an automatic, annual inflationary update (i.e., reimbursement increase) next year. In fact, there is currently a freeze on annual Medicare physician payments until 2026. After that, updates will resume at a paltry 0.25% annual rate. It is these physician payments that directly impact our ability to hire and retain medical staff and purchase needed supplies.

When we are all providing care for the same at-risk, medically vulnerable patients, it is puzzling that Congress would choose to treat physician practices differently than it does hospitals, skilled nursing facilities, hospices, or any other Medicare provider type. Making matters worse is an additional proposed cut of 4.42% in Medicare physician payments that, unless Congress acts, will go into effect on Jan. 1.

The impact of these cuts could be detrimental, not just for clinics like mine, but also for Medicare patients who may see access dwindle or disappear as a result. It is difficult enough for many physicians to run their practices efficiently and effectively under the current payment system. Further cuts would exponentially increase financial and administrative burdens, potentially forcing some physicians to turn away Medicare patients, find other ways to cut costs, or close down their practices altogether. This is especially true for rural, underserved communities and independent practices in Eastern Washington and North Idaho.

These proposed cuts should be a nonstarter for lawmakers who want to protect access to care for patients and provide economic stability in the health care sector. Fortunately, two physician legislators in the House – Reps. Ami Bera, M.D., D-Calif., and Larry Bucshon, M.D., R-Ind. – have recognized the gravity of the issue at hand and introduced a bipartisan solution to help address it.

Their Supporting Medicare Providers Act, which is currently under consideration in the House, would help provide relief for physicians and patients alike by delaying these devastating cuts for at least a year. While it is by no means a permanent solution, passing this bill would at least be a signal from Congress that our lawmakers and elected officials in Washington, D.C., understand the problems facing physicians in the aftermath of the pandemic, and hopefully give them enough time to come up with a longer-term policy solution.

On the other hand, if made worse, Medicare’s already-inadequate physician payment system could make it all-but-impossible to provide care for our nation’s aging population. We need a payment system that is simpler and more predictable for patients and physicians. Such a system must reflect the actual, real-world costs of running a physician practice in the current economic and social environment.

Our state’s entire congressional delegation – including Rep. Cathy McMorris Rodgers – should rally behind the Supporting Medicare Providers Act to help ensure stability for Washington physicians while protecting access to care for Medicare beneficiaries in the Evergreen State and across the country.

Dr. Clint Hauxwell is board certified primary care physician in at MultiCare Rockwood’s Quail Run Clinic in Spokane specializing in family medicine and a member of the Washington State Medical Association board of trustees.