Each of Washington state’s 39 counties is now designated at least partially as a “health professional shortage area,” according to the Rural Health Information Hub.
In a viewpoint article published by The Seattle Times Aug. 25., Steven Kaptik, MD, a gastroenterologist in Tacoma, Wash., outlines the forces driving the state’s ongoing physician shortage.
The challenges
Medicare reimbursement declines are a significant factor behind the decline of private practice in Washington, Dr. Kaptik writes — and 81% of physicians agree, according to Doximity’s recent “Physician Compensation Report 2025.”
While CMS’ proposed rule for 2026 includes a 3.6% bump in physician pay, many physicians argue that the change still falls short of keeping pace with inflation and the rising costs of running a practice.
“While I appreciate the sentiment behind CMS’ proposed 3.6% increase in the physician fee schedule — especially as it relates to supporting primary care physicians — the reality is that this adjustment still falls short,” Triwanna Fisher-Wikoff, MD, a family medicine physician at Texas Health Care in Fort Worth, told Becker’s. “When measured against inflation and the rising costs of running a practice, the increase does not represent a true raise. Had CMS and Congress addressed the flaws in the sustainable growth rate formula over 20 years ago — ensuring physician payments kept pace with hospital reimbursements and inflation — this increase would be far more meaningful today.”
Dr. Kaptik notes that the declines in Medicare payments to independent practices have run parallel to increases in hospital payments, often for the same services.
“That’s forcing independent practices to make impossible decisions: lay off staff, accept buyout offers from hospital systems or even close their doors entirely,” he writes.
As a result, he continues, nearly half of Washington’s physicians are now employed by hospitals, according to a 2023 report by Health Management Associates cited in his article.
The solutions
At the core of the Medicare issue is a failure to tie Medicare reimbursement to inflation, a move that has long been sought by independent physicians and their allies.
Rep. Kim Schrier, a Democrat from Issaquah, Wash., and the first pediatrician ever to serve in Congress, is an original co-sponsor of the Medicare Patient Access and Practice Stabilization Act of 2025, which would boost Medicare pay for independent physicians to offset years of cuts. The bill has strong bipartisan support, including the majority of the state’s representatives in Washington.
Ms. Schrier also co-sponsored a bill in the last Congressional session that would tie Medicare physician payments to inflation permanently.
“If our leaders can ensure these sorts of reforms make it into this year’s must=pass spending bills, it would avert disaster for many of Washington’s smaller medical practices — and thus keep medical care accessible for vulnerable seniors and costs down for taxpayers,” Dr. Kaptik writes.
