Senator Cantwell Announces the Medicare Incentive Access Act

Washington, DC - Senator Maria Cantwell (D-WA) today announced the Medicare Incentive Access Act. The legislation addresses increasing problems Medicare beneficiaries have in accessing primary health care services.

Medicare beneficiaries report increasing difficulty finding a physician willing to accept their Medicare coverage. Concurrently, providers across Washington are announcing that they will either no longer accept Medicare patients at all, or accept any new Medicare patients. According to the American Medical Association, nearly 30 percent of family physicians nationwide are not accepting new Medicare patients, and 57 percent of Washington state physicians are limiting the number or dropping all Medicare patients from their practices.

In order to address this increasingly dire situation and preserve beneficiary access to primary care providers Senator Cantwell proposes to create a new Medicare Health Professional Shortage Area (HPSA). Physicians in an area designated as a Medicare HPSA will receive an automatic 40 percent bonus on all Medicare billings. This three-year, five-state demonstration project will examine whether increasing Medicare reimbursements, while targeting limited resources to where they are most needed, will stabilize, maintain, and increase quality, efficient primary care services for Medicare beneficiaries. The demonstration project will also determine what level of incentive is necessary to prevent future access problems.

Senator Cantwell said, "I am excited to introduce the Medicare Incentive Access Act. Health care providers across the country are facing an increasingly uncertain future. The sad truth is that it is increasingly more difficult to recruit health care providers to work with underserved communities - especially in rural areas."

"I want the federal government to systematically examine different incentive programs in order to stabilize, maintain, and increase quality, efficient primary care services for Medicare beneficiaries while encourage additional providers to enter this market."

Under current law, the primary care Health Professional Shortage Area (HPSA) system focuses whether an area has a critical shortage of physicians available to serve the people living there. A HPSA can be a distinct geographic area (such as a county) or a specific population group within the area such as the low-income. However, in many shortage locations, access to care is a problem for only part of the population. For example, most residents in a city may have adequate access to care, but the elderly or poor may not. Current HPSA designations neither specifically identify nor address Medicare-related demographics.

Physicians in states participating in the Medicare HPSA demonstration project will not be able to also receive payments under the Medicare Incentive Payment program. In addition, the demonstration project will not affect current HPSA designations needed for other programs, such as Federally-qualified Community Health Centers (current law prohibits multiple HPSA designations).