Underserved area bonuses getting critical review
Underserved area bonuses getting critical review
Congress looks at ending extra payments
Congress is considering a White House proposal to change a Medicare incentive program designed to draw physicians to underserved areas. The move comes on the heels of a General Accounting Office (GAO) report that concludes the program is ineffective.
The Medicare Incentive Payment Program is on a list of federal programs Capitol Hill republicans are reviewing for possible termination or reform, note sources on the Senate Budget Committee.
From $2 million to $32 million
/>The program pays doctors a 10% bonus for Medicare Part B services in both hospital and nonhospital settings in areas with health professional shortages. To be a shortage area, a region must have a patient-to-physician ratio of at least 3,500 to one. The program cost less than $2 million in 1989, but grew to $32 million in 1991. It is expected to cost $400 million over the past five years.
"The bonus payments, amounting to $90 million in 1997, do not appear to have a significant impact on physician recruitment and retention, and most of the program’s payments are going to specialists in more urban areas rather than to primary care physicians in medically underserved areas," U.S. Comptroller General David M. Walker of the GAO testified before Congress earlier this year.
Docs want reform
Rather than dismantling the program, physician groups say it should be reformed.
"I think it would be a gross error to eliminate a program that has the potential of living up to its original expectations, which was to recruit and to permanently keep physicians and other providers in undeserved areas," says American Medical Association trustee J. Edward Hill, MD.
The AMA supports legislation extending the 10% payment bonus to physicians in rural counties where the poverty rate exceeds a certain threshold, regardless of whether the area has a shortage designation.
"To get the most bang for the buck, what Congress needs to do is limit the bonus payment to primary care and increase it to 20 to 30%," argues Darin Johnson, vice president for policy and public affairs at the National Rural Health Association, based in Kansas City, MO, and Washington, DC.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.