Washington Senate bill would reimburse doctors, nurse practitioners at same rate
In an attempt to help the state retain and attract more health care workers during the current hospital crisis, a new Washington State Senate bill would require insurance companies to reimburse advanced registered nurse practitioners at the same rate of physicians.
Senate Bill 5704, sponsored by 16 Senate Democrats, states in its opening paragraph that it was written in response to the COVID-19 health worker shortage.
“Given the gravity of the COVID-19 crisis and the threat future pandemics present to the residents of Washington, the Legislature recognizes the importance of supporting health care practitioners throughout the state,” the bill reads. “This act intends to help maintain a sufficient number of health care providers, especially in underserved and rural communities.”
More than 400 members of the public registered their support of the bill during a hearing this week, with several advanced registered nurse practitioners (ARNP) giving their experience during public comment.
Louise Kaplan, an ARNP and legislative chair of the ARNPs United of Washington, said that until recent years, insurance companies had tended to pay ARNPs and medical doctors the same amount of money; this bill, she said, would make up for those recent cuts.
“Equitable reimbursement of ARNPs will help clinics pay for the cost of delivering care to patients — it does not go directly to the ARNP,” Kaplan said.
Another ARNP, Maddy Wiley, pointed out that nurse practitioners perform many of the same tasks as physicians, such as performing exams, prescribing medicine or treatment, and giving patient referrals.
“We provide the same primary care as that of a family physician, with the same costs of staff, rent, medical supplies, utilities,” she said.
Wiley, who co-owns a clinic in Kent, added that the pandemic has made it more difficult to keep the doors open, as “COVID-19 has increased costs of medical supplies, and our office visits declined.”
Not all comments were in support of the bill, however. There was a fevered debate from physicians, with more than 200 people signing on against the bill during the hearing.
Dr. Katina Rue, who runs a family care practice in Yakima and serves as president-elect of the Washington State Medical Association, said that while she has the utmost respect and appreciation for her ARNP colleagues, there is a much bigger experience gap between the two professions than people realize.
“The bill ignores the fundamental differences in education, training, and patient panels that our physicians and ARNP colleagues manage,” she said.
She added that the higher reimbursement recognizes the additional years of education that doctors go through, pointing out that she is still paying off her medical degree 17 years after graduation.
Dr. Ashlin Mountjoy, who practices in Everett and Seattle, said the bill would just make health care more expensive for patients. She also argued that if the goal is to help access in rural areas, then this would not do so, as ARNPs tend to work in more urban areas.
“The broad payment parity strategy is a blunt tool that will raise health care costs, while neither directly responding to COVID, nor incentivizing increased access to medical care,” Mountjoy said.
The bill must pass out of committee within the next two weeks in order to be considered by the rest of the Senate this session.