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A new bill introduced in Congress this week could help doctors who provide care in office-based facilities stay open for business by bringing Medicare and Medicaid reimbursement rates more in line with actual costs.

Between 2019 and 2024, the number of independent physicians in rural areas dropped by 43 percent, according to a new Physician Advocacy Institute report.

Dr. James Albert, a registered physician in vascular interpretation at the Albert Vein Institute, treats vein disease at offices in Colorado Springs and Denver. Over the past two decades, he said, reimbursement rates have dropped dramatically.

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"At this point," he said, "our current reimbursement for technologies that have proven the test of time, and they are definitely the gold standard, is now 50 cents on the dollar of what was being paid in 2007."

Last year, the report shows, reimbursement rates for 300 services listed in the Medicare Physician Fee Schedule were below the actual cost of providing care.

House Resolution 7863 is in part a response to concerns that corporate consolidation in the health sector could drive up costs, lower care quality and exacerbate access issues, especially in rural areas. Some 7,300 independent medical practices were either closed or acquired by corporations between 2019 and 2024.

Office-based facilities provide high-tech, minimally-invasive procedures in cardiology, pain management, physical therapy, urology and other fields. Because these services don’t require general anesthesia and backup from operating rooms and intensive-care units, they tend to be more affordable.

Albert said keeping office-based facilities open for business is a cost-saving proposition.

"The office-based practice provides these services at up to 15, 20 times less than what would be done in the hospital," he said.

Albert noted that when independent practices shut down, patients have no choice but to seek more expensive, hospital-based care.

"In Colorado Springs, we are now the only physician-based practice treating vein disease in the office," he said. "All the other ones have closed. And in Denver, many of the offices have ended up being purchased by private equity."