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Finkenauer legislation would improve Medicare reimbursement rates for Iowa

U.S. Rep. Abby Finkenauer, D-Iowa, who spoke at St. Luke’s Center for Women’s and Children’s Health in Cedar Rapids on Monday, is seeking support from both parties to bring more equity to Medicare reimbursement rates for Iowa. She is shown here at her campaign office in Cedar Rapids in 2018. (Rebecca F. Miller/The Gazette)
U.S. Rep. Abby Finkenauer, D-Iowa, who spoke at St. Luke’s Center for Women’s and Children’s Health in Cedar Rapids on Monday, is seeking support from both parties to bring more equity to Medicare reimbursement rates for Iowa. She is shown here at her campaign office in Cedar Rapids in 2018. (Rebecca F. Miller/The Gazette)

CEDAR RAPIDS — First District U.S. Rep. Abby Finkenauer is continuing a fight to improve Medicare reimbursement rates for Iowa health care providers and thinks there may be an opportunity to bring more equity to the system that she says handcuffs physician recruitment and retention efforts.

“To get things done in Washington right now, you’ve got to find common ground where you can work across the aisle,” she said Monday at St. Luke’s Center for Women’s and Children’s Health in Cedar Rapids.

Finkenauer, a first-term Democrat, is working with Midwest members of both parties to build support for her Keep Physicians Serving Patients Act of 2019.

“It shouldn’t matter where you live, and what the population is. You should be able to get top-notch care,” Finkenauer said.

The problem, Finkenauer said, is that Iowa has the seventh-lowest Medicare reimbursement rate in the country, meaning many providers struggle to cover the cost of treating Medicare recipients.

This is aggravated by Iowa’s aging population, many of whom rely on Medicare, added ophthalmologist Brian Privett of Iowa Eye Center in Cedar Rapids, president-elect of the Iowa Medical Society.

Finkenauer’s legislation would adjust the geographic practice cost index to accurately reflect the cost of labor and practice expenses. The current formula underestimates those costs in rural areas, which can often be higher than in urban areas.

She’s not the first member of the Iowa congressional delegation to go to bat on this issue, said Dustin Arnold, chief medical officer of UnityPoint Health-St. Luke’s, who noted that receiving the seventh-lowest reimbursement rate is an improvement.

When first established, the rate took into consideration differences in costs from one geographic region to the next, he said. However, overhead costs and regulatory costs have eliminated most geographic cost variables, Arnold added.

Also, most purchasing is done through national vendors, so there is little difference in the price of supplies from one region to the next.

At present, the difference between the reimbursement Iowa Medicare providers receive and other areas works out to about 5 percent, said Dennis Tibben, the director of external affairs for the Iowa Medical Society. That is based in part on flawed date that includes residential rental costs rather than commercial office space costs and data for professions other than health care.

The lower reimbursement rate, which in many cases doesn’t cover the full cost of services, makes physician recruitment and retention costlier, Tibben said. Hospitals and clinics often have to pay a premium to recruit physicians. However, if the reimbursement rate doesn’t cover costs, then hospitals and clinics aren’t able to offer physicians higher salaries to recruit them to Iowa.

“When we’re 43rd in country in the number of physicians per capita, we need every tool available in the toolbox to be able to recruit,” he said.

For more on her proposal, visit https://finkenauer.house.gov/.

• Comments: (319) 398-8375; james.lynch@thegazette.com

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