Source: United States House of Representatives – Congressman Jimmy Panetta (D-Calif)
Washington, D.C. – United States Representative Jimmy Panetta (CA-19) joined Reps. Kim Schrier, M.D. (WA-08), John Joyce, M.D. (PA-13), and Greg Murphy, M.D. (NC-03) in introducing the bipartisan Patients First Act, comprehensive Medicare Access and CHIP Reauthorization Act (MACRA) reform legislation. The Patients First Act would make necessary changes to keep patients healthy, preserve competition, and deliver affordability.
The legislation includes Rep. Panetta’s longstanding priority of reforming the Medicare physician fee schedule, improving seniors’ access to care by strengthening the incentives to keep doctors in practice, improving access to primary care physicians, and stabilizing the cost of care.
Rep. Panetta also co-leads the Strengthening Medicare for Patients and Providers Act to protect seniors’ access to care by ensuring Medicare keeps pace with rising health care costs. The bill helps prevent doctor shortages in Medicare by indexing payments to inflation to ensure they better reflect the real cost of delivering care, especially in rural, underserved, and low-income communities. This year he passed legislation to end Medicare Advantage “ghost networks” and joined a bipartisan group of lawmakers to reform Medicare Advantage payments and end prior authorization abuses.
“Medicare patients in California’s 19th Congressional District are facing significant barriers to care, with practices closing, physicians leaving the community, and monthslong wait times for even a checkup,” said Rep. Panetta. “I’m proud to cosponsor the bipartisan Patients First Act to stabilize doctors’ practices and payments, cut red tape, invest in primary care, and increase choice for patients, ensuring seniors have access to the care they’ve earned. I am also proud this legislation includes my longstanding priority to attach Medicare rates to inflation. This is the type of bipartisan work necessary to help doctors and patients alike.”
“Our nation is in a primary care crisis, and if we don’t act swiftly to reform the system, patients will lose access to care, costs will rise, and physician practices will continue to close,” said Rep. Schrier. “Consolidation in our healthcare system is forcing small, independent physicians to sell their practices to corporate entities, decreasing choice and competition, and increasing costs for patients without delivering better quality. This bill gives stability to independent practices, reduces red tape and burdensome paperwork, and invests in primary care. By introducing the Patients First Act, we are addressing the challenges physicians face with a commonsense, bipartisan solution. Patients deserve better, and this bill delivers on that promise.”
“The House of Medicine is at a crossroads. We can maintain the status quo that rewards more costly, less personalized care, or we can put our heads together to build a modern framework that addresses the challenges that impede physicians’ ability to care for their patients,” said Rep. Joyce. “We often talk about expanding access to high-quality care, but without meaningful Medicare reimbursement reform, that mission becomes nearly impossible to achieve. Putting patients ahead of politics, we worked together to develop this comprehensive legislation to address a system that has for far too long undermined patient access to affordable, physician driven care within their communities. We can and must do better. This proposal deserves serious consideration because the future of patient care, the strength of our physician workforce, and the survival of independent practice all hinge on whether we choose to act rather than accept inaction.”
“As a practicing urologist for more than 30 years, I’ve seen firsthand the challenges physicians face in keeping their doors open while providing the highest quality care for their patients,” said Rep. Murphy. “Our current Medicare physician payment system is unsustainable. It has fueled consolidation, increased administrative burdens, and made it harder for independent physicians in rural communities to continue serving the patients who rely on them. The bipartisan Patients First Act delivers long-overdue reforms that strengthen independent practices, invest in primary care, and ensure physicians can spend more time caring for patients instead of navigating bureaucracy. When physicians succeed, patients receive better care, and that’s exactly what this legislation is designed to achieve.”
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is bipartisan legislation signed into law on April 16, 2015. The law:
- Repealed the sustainable growth rate (SGR) methodology for determining updates to the Medicare physician fee schedule (MPFS),
- Established a merit-based incentive payment system (MIPS) to consolidate and replace several existing incentive programs, and
- Incentivized the development of, and participation in, alternative payment models (APMs).
Specifically, the Patients First Act:
- Ties physician reimbursement to an inflationary measure.
- Establishes a primary care hybrid payment pilot program that pays Primary Care Providers (PCPs) a per-member-per-month payment along with regular services, better capturing the work PCPs do.
- Establishes the POINTS program, which creates a physician and clinician-led task force at the Centers for Medicare & Medicaid Services to develop quality metrics that are streamlined and reduce administrative burden.
- Freezes Advanced Alternative Payment Model participation thresholds for three years and creates notice and comment periods for Center for Medicare and Medicaid Innovation mandatory models.
- Increases the budget neutrality threshold from $20 million to $54.3 million.
Running an independent physician practice is costly, with physicians increasingly forced to either close their doors or sell their practices due to low reimbursement rates and increasing practice expenses. When physician practices are acquired, patients are often left with fewer and more costly options for care.
Not only is care becoming more consolidated and costly, America is also facing a primary care crisis. Primary care providers foster a lifelong relationship with patients and provide disease prevention, treatment, and management. Today, less than five cents of every Medicare dollar goes to primary care, even though it accounts for more than half of all physician visits. It’s no coincidence that more than 100 million Americans don’t have access to regular primary care.
More information on the Patients First Act is available here.
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