Iowa 1st District Congresswoman Abby Finkenauer is sponsoring legislation aimed at increasing pay for rural doctors serving Medicare patients. Advocates say a federal government policy of reimbursing doctors at lower rates in smaller and more remote communities is contributing to provider shortages.
Rural doctors across the U.S. are struggling to care for elderly patients and keep their practices open. Advocates say one issue is the federal government pays rural doctors less than their urban counterparts for providing services to Medicare recipients, based on geographic location.
The formula, known as the geographic practice cost index or GPCI, is meant to account for cost of living differences across the country, but providers in rural states say it’s not covering some expenses.
Iowa Medical Society President-Elect Brian Privett says these reimbursement rates make it harder to hire new providers.
“Without immediate action Iowa will fall further in the competition to recruit the next generation of physicians. And our seniors will face greater difficulty in accessing necessary medical care,” Privett said.
Rural health advocates in Iowa say the current reimbursement rates can make it harder for physicians to practice, and have ripple effects throughout the economies of small communities in the state.
"In rural communities, your hospital is at times the citadel of healthcare in the community, particularly with school consolidation. And at times it's the last bastion of employment that isn't on the farm. And this legislation will help address that," said Dustin Arnold, Chief Medical Officer of Unity Point-St. Luke's in Cedar Rapids.
Now Finkenauer, a Democrat, is introducing a bill with bipartisan support that she says would change this funding formula in a way that would benefit rural providers.
“For decades Iowa doctors have been shortchanged by a government formula that underestimates the cost of labor and practice expenses. And for two decades our healthcare providers have asked for an accurate formula, one that allows them to stay open and keep serving their patients,” Finkenauer said. "The government should be making it easier, not harder for our doctors to serve Iowans."