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December 14, 2022

Access to Care Will Continue to Diminish In Washington Without Intervention, New Survey Reveals

SEATTLE, WA - Results from a new survey indicate inflation and staffing shortages continue to severely strain Washington's medical practice community and hinder patients' ability to access care during a crucial period of recovery our state. If actions are not taken to shore up the outpatient practice community, access to care in our state will continue to diminish over the next year, creating even more pressure on our already overwhelmed hospitals.

The survey* focused on practices that are not affiliated with a hospital system and are often the only care provided in some communities, including underserved and rural areas. Eighty-two physician practices responded, representing more than a thousand physicians and health care professionals that provide care to millions of Washingtonians.

Survey toplines:

  • Nearly 50% of respondents noted their practice has had to reduce patient access, including reducing office hours, services, and treatments, in response to staffing shortages.
  • More than 30% have had to reduce patient access, including reducing office hours, services, and treatments, in response to inflation.
  • Nearly 50% have had to limit the number of Medicaid patients they see due to the practice's current financial statement.
  • Fewer than 10% have the minimum available cash required for operating expenses ("days cash on hand," defined as 18 weeks' worth), with nearly half of practices having less than four weeks' worth of available cash.
  • Just over 50% expect further reductions in patient access a year from now if staffing and financial trends continue
  • Increasing Medicaid reimbursements and reducing staffing strain from prior authorization requirements were the most commonly cited solutions to easing the pressures experienced by practices.

Survey respondent TRA Medical Imaging, which provides imaging services for over a million South Puget Sound patients in multiple outpatient clinic locations, has been forced reduce office hours as well as access to treatments, and is experiencing severe patient backlogs. TRA President and practicing radiologist Douglas Seiler, MD, said, "This is a very difficult time for our clinics. The last thing we ever want to do is reduce the care we provide to our patients, but in this economy, stagnant reimbursements and insurer requirements that add significantly to our practice and staffing costs leave us little choice."

"The WSMA is concerned that there may be patients facing problems accessing basic care in their communities, and if we don't prioritize our community practices and clinics now, the problem will only get worse" said Jennifer Hanscom, chief executive officer of the WSMA, representing nearly 12,500 physicians and physician assistants statewide. "These community practices are critically needed to prevent increasing volume and strain on our already stressed hospital emergency departments, and in the long-term, to support the ability of patients to access care in their communities."

The WSMA is urging Washington lawmakers and patients to support two initiatives in the upcoming state legislative session that could help keep practices open and patient care widely available:

  • The WSMA is asking the Legislature to raise Medicaid rates for all physician specialties to adequately cover expenses, as physician groups overwhelmingly report that doing so will help stabilize finances and maintain access for current Medicaid patients or help increase their Medicaid caseloads. Today, Medicaid covers 30% of the state's patient population, and while businesses in other industries may increase prices to address inflation, medical practices seeing Medicaid patients are constrained from doing so as the state legislature sets Medicaid rates.
  • The WSMA will support legislation that would reduce administrative burden by reining in insurance carrier prior authorization practices, which limit access to care for patients and would also relieve staffing challenges currently felt by most of the physician community.

"Physician practices and ambulatory surgery centers are the first line of defense for patient health, and it's essential that they are supported to ensure patients can get basic care and have their health needs managed and addressed at the right time and at the right place," Hanscom said. "Raising Medicaid rates and reducing staffing pressures from burdensome prior authorization insurer requirements would be a shot in the arm for our practices-and for some, a lifeline-by helping to keep doors open and care available to all Washingtonians when and where they need it."

Interview opportunities with some physicians who participated in this survey are available.

*The survey was shared in October and November with 5,000 physicians working in independent (non-networked) physician clinics. 26% of survey respondents were solo practitioners. 44% were in practices of 2-10 physicians and 7% were in practices of 11-20 physicians. 12% of respondents represented practices of 21-50 physicians, and 11% represented practices with over 51 physicians.

For more information, contact:

Cindy Sharpe
Communications, Washington State Medical Association / 813.244.2883

About the Washington State Medical Association
The WSMA represents nearly 12,500 physicians, physician assistants, resident physicians, and medical students across all specialties and practice types in Washington state. The WSMA has advocated on behalf of the house of medicine for more than 125 years. Our vision is to make Washington state the best place to practice medicine and receive care.

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