With the influx of insured patients skyrocketing due to the Affordable Care Act (ACA) as well as our growing and aging population, the demand for primary care physicians is at an all-time high. By 2020, the Health Resources and Services Administration (HRSA) has predicted that we will be in need of 20,400 more primary care physicians to sustain the amount of insured patients that will need care. The increase in patients alone is sure to add stress to doctors, but they now have to deal with deciding whether or not to accept Medicare and Medicaid patients and also must be aware of what type of penalties they might face if they are not meeting the standards of the ACA.
HRSA defines a shortage of primary medical care providers as having a physician to population ratio of 1: 3500, though there are other factors in determining a shortage. The major issue is the fact that there are not enough doctors to sustain the population’s health. These Health Professional Shortage Areas (HPSAs) are typically rural areas in which the doctor is either excessively distant or not accessible to the population. The HRSA has deemed 6,100 areas as Primary Care HPSAs.
Aside from there already being a huge shortage in many rural areas, deciding whether or not to accept Medicare and Medicaid patients can lead to a painstaking process. If physicians do agree, their patients will face more difficulty trying to schedule appointments, and the doctors could become overwhelmed extremely easily. Though Medicaid payments were raised to meet Medicare payments in 2013 and 2014, Medicaid payments will drop substantially in 2015. This leaves many primary care physicians with the decision of whether to drop all Medicaid patients or continue providing care, despite the decrease in payments.
Additionally, the Affordable Care Act is now able to penalize doctors for not meeting their standards. One standard that is currently causing a lot of concern is the Electronic Health Record (EHR), a digital version of a patient’s paper chart containing all of their health records. Though many have agreed this is the future of health care, there are some who question the immediate need to penalize those who haven’t complied with the ACA and switched over to EHRs. Many doctors will now see their Medicare payments cut by 1 percent for failing to meet the EHR standard. A study done by the Physicians Foundation found that only 24 percent of physicians say it has improved their efficiency.
With the added stress from the influx of patients, the pending shortage crisis in 2020, and the potential penalties primary care physicians could face for not meeting the standards set by Medicare, primary care physicians are sure to face difficult years ahead. Since primary care physicians are already paid less than any other physicians, the government should attempt to create incentives for students in medical school to become primary care physicians. Considering doctors pay around the same for medical school regardless of their specialty, the government could look into lowering tuition for those who are primary care physicians. That could potentially lead to an influx of physicians since they will have less debt. The government could also try to postpone the payment cuts in order to lessen the burden on the doctors. By working with the doctors, our government can be a huge factor in making great strides in improving the quality of care.