Removing Barriers to Care for Physician Assistants
Tuesday, June 23, 2020
Posted by: Stephen Gillies
Dear MAPA Members,
First of all we want to thank you for your continued work during the COVID-19 Pandemic and we hope you all are staying healthy. This has not been an easy few months each and every one of you have stepped up and continually provided the absolute best care to our patients. You have shown the MA Legislators, healthcare leaders, medical colleagues, and patients what PAs are capable of.
We have exciting news to share and future work that needs to be accomplished.
Click here to view the statement
Through the hard work of the MAPA Legislative Team and Charles Group Consulting, we submitted an amendment to the Senate Bill “An Act Putting Patients First” sponsored and filed by Sen. Harriette Chandler as we advance toward Optimal Team Practice. The filed legislation if passed, will remove barriers to PA practice, increase access to our patients, and decrease unnecessary healthcare costs.
***We will soon need your help to call and email your elected officials as we work to advance this bill through the Senate, House, and the Governor. Please pay attention to your emails in the next few days regarding a letter to send to your local elected officials.***
Currently, a PA practicing in Massachusetts must have a “Supervising Physician” on file with the Commonwealth (MGL Chapter 112, Section 9E). However, the structure of our healthcare systems has changed dramatically in the 50 years since the PA profession was founded in the mid-1960s. When PAs first began practicing, most PAs and physicians worked together directly in a solo or small private practice. The proposed legislative language would streamline service, increase access to care, bring down healthcare costs, and allow PAs in Massachusetts to practice at the top of their license. Specifically, it would remove the statutory requirement that a PA must file a “Supervising Physician,” providing flexibility for hospitals and individual practices to determine the structure that enables them to provide the best care.
Laws that require a specific relationship between PAs and physicians interfere with their ability to make practice-level decisions about patient care teams. When a PA isn’t required to have a specific relationship with a physician, PA employers (health systems, hospitals, and group practices) can be more flexible in creating healthcare teams. This will allow them to more effectively meet patient needs. Ending the relationship requirement between a PA and physician removes physician liability for the care that PAs provide when physicians are not involved. It also reduces physician and employer risk of disciplinary action for administrative reasons.
Numerous studies have shown that PAs provide high-quality patient care and bring value to patients and PA employers. Eliminating the legal requirement for a specific relationship between a PA and physician will make it easier for PAs to practice in medically underserved communities where there are not enough physicians (and in some cases, no physicians) to care for patients. PAs would also be able to provide volunteer medical services and respond to disasters and emergencies — situations in which a physician might not be available or willing to enter into a legal arrangement with PAs but immediate care is needed.
Increasing practice flexibility will help ensure that patients are seen in the right setting, by the right provider, at the right time — which can reduce the overall cost of healthcare. Eliminating disparities between PAs and other healthcare providers in professional regulation and payment arrangements will help modernize PA practice and better meet healthcare needs.
Unlike physicians and advance practice nurses (APRNs), which include NPs, PAs are not eligible for direct payment from Medicare and nearly all commercial insurance payers. Most payers require that payment be made to a PA’s employer, which can unintentionally limit PA employment opportunities with staffing companies and in certain practice arrangements. As the healthcare system continues its rapid transformation toward more innovative care models, PAs must have the same reimbursement flexibility enjoyed by other healthcare professionals so they are not disadvantaged in the marketplace.
We are excited to have this amendment filed and look forward to your continued membership and support of MAPA. Pay attention to your email and our Facebook page over the next few days for additional updates.
MAPA Legislative Team
Joshua Merson, MS-HPEd, PA-C
Sarah Christie, MS, PA-C
Director at Large
Jason Parente, MPAS, PA-C
Cole Turno, MS, PA-C
Director at Large
Duncan Daviau, MS, PA-C