Support for PAs Grows Among Patients, State Regulators

January 30, 2015

Recent research indicates that PAs can improve the healthcare system, and recent policy changes help ensure that they have the opportunity to do so.

I have always believed in the utility and economy of PAs within our healthcare system. A rising tide of research and data shows what those of us in the PA profession have always known to be true: PAs are a cost effective, efficient, and in-demand solution to provide care for the increasing population in our healthcare system.

The Affordable Care Act (ACA) has created a solution and a problem within the United States healthcare system. It provides a means to cover many more individuals who previously were either uninsured or underinsured. The expansion of obtainable insurance services, however, means that the amount of people in the healthcare system is growing. We need to ensure that there is adequate and versatile number of healthcare providers who have the capacity to provide these critical primary-care services.

In a paper to be published this February, authors Roderick S. Hooker, PA, and RAND Corporation Assistant Policy Analyst and doctoral candidate Ashley N. Muchow found that improving PA and NP practice laws and regulations would eliminate many barriers to care and enable states to save millions of dollars in healthcare costs.

The authors used the state of Alabama, which has the most restrictive regulations as they relate to the practice of PAs and NPs, as the case study for the paper. Alabama has significant rural and medically underserved areas and populations, leading to many health disparities throughout the state. Additionally, Alabama also has the lowest proportion of PAs and NPs as a percentage of total primary-care providers in the state.

This low proportion of PAs makes total sense. States which meet the model legislation standards of the American Academy of Physician Assistants (AAPA) typically have a much higher proportion of PAs and NPs serving as primary-care providers. PAs and NPs want to practice in nonrestrictive, supportive environments. While there are many other factors affecting the deployment of healthcare providers within our healthcare system, removing this barrier to addressing healthcare disparities in medically underserved areas of the United States would draw more providers to underserved areas and provide more medical resources for those in need.

As Hooker and Muchow note, training and deploying PAs within the healthcare system adds value and is cost-effective. PAs perform many of the routine functions needed within the primary-care healthcare system of the United States and are leaders in team-based care. In many medical practices, PAs contribute significantly to the health and well-being of the patients served and are in high demand from both patients and employers. In fact, Forbes recently listed PAs as the most promising job of 2015 based on data from salary website Glassdoor.

Also, a study conducted by Harris Poll on behalf of AAPA surveyed more than 1,500 U.S. adults. Among an oversample of 680 Americans who have interacted with a PA in the last year (meaning either they personally saw a PA or were present for the visit of someone they care for), the survey revealed strong support for the care PAs deliver:
• 93 percent agree PAs are going to be part of the solution to address the shortage of healthcare providers.
• 93 percent agree PAs are trusted healthcare providers.
• 91 percent agree PAs improve health outcomes for patients.
• 91 percent agree PAs improve the quality of healthcare.

Couple this with the fact that PAs are trained using an in-depth medical model similar to physicians, and you have a practice-ready solution to the healthcare workforce shortage. In order to ensure greater primary and preventative care access and address the healthcare disparities confronting both individuals and our healthcare system, we must maximize the utility of PAs and NPs.

State regulations are starting expand to accommodate all of the various players within the ranks of healthcare providers. Recently, California PAs won removal to a barrier to care when the Medical Board of California adopted a rule revision that allows PAs to act as first or second assistant in surgery without the personal presence of the physician. Just this past December, the Kentucky Board of Medical Licensure (KBML) voted to abolish the requirement that physicians and PAs maintain proximity within 30 minutes.

Not only does the recent research and data point to PAs as valuable providers who add value to healthcare services, these policy changes can have significant economic benefits by reducing health disparities that drive up healthcare costs by greatly expanding access to primary-care services for many underserved men, women, and children across America.

This blog was provided in partnership with the American Academy of Physician Assistants.