Bill Overview
Title: Physicians for Underserved Areas Act
Description: This bill modifies how a hospital's residency positions are redistributed after it closes for purposes of graduate medical education payments under Medicare. Under current law, if a hospital with an approved medical residency program closes, the Centers for Medicare & Medicaid Services (CMS) must redistribute the hospital's residency positions to other hospitals in the following order: (1) hospitals in the same core-based statistical area as the closed hospital, (2) hospitals in the same state as the closed hospital, (3) hospitals in the same region of the country as the closed hospital, and (4) other remaining hospitals. In order to receive the additional positions, hospitals must demonstrate a likelihood of filling the positions within three years. The bill removes the requirement that the CMS prioritize hospitals in the same region of the country as the closed hospital. It also requires hospitals to demonstrate a likelihood of (1) starting to use the positions within two years, and (2) filling the positions within five years.
Sponsors: Sen. Rosen, Jacky [D-NV]
Target Audience
Population: All people who rely on healthcare services
Estimated Size: 331000000
- The bill impacts the allocation of residency positions for closed hospitals, which affects the training of new doctors.
- The redistribution affects how hospitals fill their medical residency positions, impacting their staffing capabilities.
- Changes in residency redistribution can impact access to healthcare in underserved areas, as it could shift physicians to those areas.
- Physicians are a crucial part of the healthcare delivery system, so their distribution affects the entire population's access to medical services.
Reasoning
- The policy affects the distribution of medical residency spots, which will primarily impact medical students and hospitals, especially those in underserved areas.
- Residency positions are crucial for the training of new doctors, so changes in their distribution can have long-term effects on healthcare access.
- Hospitals in underserved areas might benefit from this policy as it could allow them to attract more residents quickly.
- The general population's wellbeing is indirectly affected through the quality and availability of healthcare services.
- Not everyone will be directly impacted – those in urban areas with an abundance of medical professionals may not notice changes.
Simulated Interviews
Medical Student (Austin, TX)
Age: 30 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- As a medical student, I'm relieved to hear that residency positions might be more evenly distributed, especially towards underserved areas. It increases my options.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Family Physician (Rural, IA)
Age: 45 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- Having more medical residents in our rural hospital could significantly improve healthcare delivery. I'm hopeful about this bill.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 9 | 7 |
| Year 3 | 9 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Hospital Administrator (Los Angeles, CA)
Age: 38 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 4/20
Statement of Opinion:
- I'm concerned this might divert some potential residents to other states, but if it helps underserved areas, it's positive overall.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Retired (New York, NY)
Age: 62 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 6/20
Statement of Opinion:
- Access to healthcare is critical, especially as I age. This bill might ensure there's enough healthcare providers where they're most needed.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Internal Medicine Resident (Miami, FL)
Age: 28 | Gender: other
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- I'm concerned about job prospects post-residency, so an equitable distribution of residencies is important for my future.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Public Health Official (Atlanta, GA)
Age: 50 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- This policy is a step towards improving healthcare equity by ensuring more medical professionals are available in underserved areas.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Tech Worker (Seattle, WA)
Age: 33 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 8/20
Statement of Opinion:
- I don't expect this policy to impact me directly, but it's good to know it might help others get better access to healthcare.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 6 | 6 |
General Surgery Resident (Chicago, IL)
Age: 29 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 4/20
Statement of Opinion:
- Redistribution might affect my career trajectory, but overall it's vital for underserved areas to have enough physicians.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Nurse (Cleveland, OH)
Age: 54 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 4/20
Statement of Opinion:
- More residency spots might mean more staff in the long term, which is much needed for reducing workload.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Retired Army Veteran (Phoenix, AZ)
Age: 65 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- Anything that potentially increases the number of doctors could improve services, especially in places like the VA.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Cost Estimates
Year 1: $20000000 (Low: $15000000, High: $30000000)
Year 2: $22000000 (Low: $17000000, High: $35000000)
Year 3: $24000000 (Low: $19000000, High: $40000000)
Year 5: $30000000 (Low: $25000000, High: $50000000)
Year 10: $35000000 (Low: $30000000, High: $60000000)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The need for investment in healthcare infrastructure in underserved areas.
- Potential resistance from hospitals in losing nearby residency positions to more distant facilities.
- The feasibility of hospitals meeting the new timelines for residency position utilization.
- Impacts on residency training quality due to potential reshuffling of resources.