Each considered one of Washington’s 39 counties is now designated a minimum of a partial “well being skilled scarcity space” by the federal authorities, which means there aren’t sufficient docs general, or in sure specialties, to fulfill sufferers’ wants. Rural areas, specifically, are struggling to draw and retain sufficient physicians.
Medicare’s flawed reimbursement formulation deserves a number of the blame for this ongoing, worsening scarcity. For years, Medicare’s pay for “unbiased” docs unaffiliated with hospitals has been on the decline — even because it’s been rising for hospitals.
That’s forcing unbiased practices to make not possible selections: lay off workers, settle for buyout presents from hospital techniques and even shut their doorways totally.
The demise of unbiased practices isn’t simply dangerous for his or her workers and homeowners. It finally means larger prices and worse service for sufferers and taxpayers. That’s why it’s so essential for Congress to repair the issue when it returns to the nation’s capital this fall.
As an unbiased doctor practising in Auburn, Tacoma and Puyallup, I do know firsthand how tough it may be to function a financially sustainable medical observe. Hire, labor and different operational prices are on the rise. However Medicare reimbursement charges for physicians decreased in 2025 for the fifth yr in a row. Adjusted for inflation, Medicare reimbursements to physicians have fallen by one-third since 2001.
Hospital reimbursements, in the meantime, are mechanically listed to inflation. Hospitals additionally cost a number of occasions greater than unbiased physicians for the very same exams, scans, procedures and different well being care providers.
In consequence, many massive hospital techniques have a monetary incentive — to not point out extra money — to accumulate unbiased practices or rent away their docs. From 2019 to 2024, hospitals nationwide acquired nearly 8,000 doctor practices and employed almost 75,000 physicians.
It’s the identical story right here in Washington. Roughly half of Evergreen State physicians at the moment are employed by hospitals.
The structural benefits loved by hospitals may be insurmountable for personal practices. We’re pressured to not solely overcome declining reimbursement but additionally compete for expertise with hospitals that supply above-market pay. I do know of a number of practices that cite issue recruiting new physicians as the first cause they’ll finally be pressured to shut or promote to a hospital.
The ramifications for sufferers are vital. Unbiased practices usually ship higher-quality and extra personalised care at decrease price than massive hospitals. And sufferers handled at smaller physician-owned practices have lower rates of preventable hospital admissions.
Failing to peg Medicare reimbursement to inflation — mixed with years of actual cuts in pay — will put many of those docs out of enterprise or drive them to hitch bigger hospitals in additional populous areas. That may depart hundreds of sufferers, particularly in additional rural areas, with no native, accessible supply of care.
Happily, Washington’s congressional delegation is main the cost to repair the issue. U.S. Rep. Kim Schrier, D-Issaquah, the first pediatrician to ever serve in Congress, is an original co-sponsor of the Medicare Affected person Entry and Apply Stabilization Act of 2025, which might enhance Medicare pay for unbiased physicians to offset the cuts in recent times. The invoice enjoys substantial bipartisan assist — 177 members of the Home again it, together with a bipartisan majority of Washington’s representatives.
Rep. Schrier additionally co-sponsored a invoice within the final Congress that might completely repair the issue — by indexing unbiased physicians’ Medicare reimbursements to inflation, simply as Medicare already does for hospitals and nursing houses.
If our leaders can guarantee these types of reforms make it into this yr’s must-pass spending payments, it will avert catastrophe for a lot of of Washington’s smaller medical practices — and thus preserve medical care accessible for weak seniors and prices down for taxpayers.
