Senator Maria Cantwell from Washington will introduce 2 Senate bills. One is the equivalent of HR#2350. Press Release of Senator Cantwell
Specifically, the Preserving Access to Primary Care Act would help provide efficient, prevention-oriented care throughout the country. It would also reward Medicare providers that offer well managed primary care and incentivize other providers to adopt better practices by:
* Establishing scholarships and loan forgiveness in exchange for primary care service commitments in critical shortage areas;
* Creating grants for medical school mentorship programs and primary care training in community health centers;
* Increasing Title VII and National Health Service Corps funding for primary care training;
* Removing caps on the number of residencies funded by the Medicare GME program with a preference for the new residencies given to primary care;
* Eliminating barriers to increased training in ambulatory care settings for primary care trainees; and,
* Enacting Medicare payment reforms to support the value of primary care in improving quality, coordinating care and reducing costs, and a transition to a new payment system based on the Patient Centered Medical Home.
The second bill, The Physician Workforce Enhancement Act, would improve access to health care by increasing the number of doctors trained in the specialties people need most, like family medicine, internal medicine, pediatrics, and behavioral and mental health by:
* Creating an interest-free loan program for hospitals committed to starting new residency programs in one of these in-demand specialties; and
* Providing financial assistance to hospitals to create residency programs in underserved rural areas.
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Hospital-based residency programs primarily train residents to practice in hospitals. A resident out in the community is a cost without much (any?) benefit to the hospital. This is why hospital training programs try to teach outpatient medicine in ‘continuity clinics’ and other mechanisms that don’t take the residents off the hospital rotations.
So hospital-based residency programs may increase the number of hospitalists, but why would they improve the supply of outpatient primary care physicians?