Medicaid Primary Care Improvement Act

Floor Speech

Mr. Speaker, I rise in support of H.R. 3836, the Medicaid Primary Care Improvement Act, sponsored by Representative Crenshaw from Texas and myself.

As a primary care physician and a Congresswoman, I am excited to see the Medicaid Primary Care Improvement Act come to the floor today.

Allowing Medicaid to utilize the direct primary care model is a huge shift in the way that Medicaid patients and doctors interact for the better. Direct primary care is structurally different than traditional care models, because it is not designed around fee-for-service billing, but, rather, focused entirely on providing patients the best care possible.

This is made possible by having Medicaid pay an affordable monthly fee that, in turn, allows doctors with a set number of patients the time and flexibility to provide the best possible care and the ability to schedule appointments that are the right length in order to provide all of the support those patients need for optimal health.

Some appointments might take 90 minutes. Some might take 10. In the direct primary care model, doctors have a number of patients, or a patient panel, that they are responsible for caring for, and a smaller patient population means more time spent on things like education, preventative care measures, and being able to talk through and address critical topics like nutrition, exercise, stress, and social determinants of health that can't always be thoroughly addressed during a typical time-limited primary care appointment.

In turn, this means better patient understanding of and involvement in their own healthcare, fewer visits to the emergency room, and ideally better outcomes. Other trials of direct primary care have shown exactly those outcomes.

Dr. Garrison Bliss is a pioneer in this effort, starting up the first direct primary care practice in Washington State in 1997. His last year in practice was 2020, the year we were met with COVID. He had just 450 patients with the average patient in their midsixties. Their age put them at an increased risk for COVID morbidity and mortality, and patients in this age group generally require more care or just a smaller-sized panel.

Not a single one of his patients died from COVID during that first year, when we still didn't have vaccinations or treatments and we were still learning about the disease. He credits this to the fact that he could reach them, and they could reach him readily and have conversations about their care and talk with them about their COVID concerns.

He could send out newsletters directly with pertinent information. If his patients had a question about whether or not to go to the emergency room, he was available to give advice by being there for his patients. Consulting with him prevented ER visits with no compromise in care.

This model of care deserves to have more pilots around the country, hopefully with similar results, better outcomes, lower costs, tighter relationships between doctor and patient, and improved patient and physician satisfaction.

If these benefits are consistently achieved, then all people, no matter their level of income or insurance, deserve the option of a direct primary care model, including Medicaid.

I encourage all of my colleagues to vote ``yes'' on H.R. 3836.

Mr. Speaker, I have no further speakers, and I reserve the balance of my time.

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Ms. SCHRIER. Mr. Speaker, I have no further speakers.

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Ms. SCHRIER. Mr. Speaker, whatever we can do to expand affordable care, improve healthcare, strengthen the doctor-patient relationship, and bring down costs is a win for our constituents. That is why I am excited to sponsor this bill, the Medicaid Primary Care Improvement Act, that allows the use of direct primary care.

Mr. Speaker, I encourage my colleagues to vote for this bill, and I yield back the balance of my time.

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