Policy & Practice
Physician Assistants Deeply Disappointed in Governor Baker’s Healthcare Bill: Ignores Critical Role PAs Play in Cost Containment and Preventive Care
The Mass. Association of Physician Assistants (MAPA) is deeply disappointed by the healthcare bill released by Governor Charlie Baker on Friday, October 18th.
Governor Baker’s healthcare cost containment bill (H4134, An Act to improve healthcare by investing in VALUE ) purports to reduce healthcare costs by prioritizing primary care and improving access to high-quality, coordinated care. The Governor’s press release itself states, “The legislation aims to invest in team-based approaches to treat the whole individual in order to improve health outcomes and decrease costs over time… The Commonwealth has some of the most restrictive practice requirements governing mid-level practitioners.” The release goes on to note that loosening some of theserestrictions have shown immense cost savings and increases in quality of care in other states. MAPA is well-aware of the benefits of preventive care and comprehensive primary care - as PAs have been practicing as primary care providers in Massachusetts since 2012, as part of a team-based model, and as a mid-level practitioner.
And yet - Governor Baker’s bill is solely focused on expanding the role of nurse practitioners, creating a dental therapist, and expanding the role of optometrists and podiatrists. While these are all noble pursuits to which MAPA is not opposed, the bill completely ignores the role of one of the most critical, fastest-growing, and effective mid-level healthcare professions: physician assistants.
Perhaps even more alarmingly, the legislation explicitly creates a hierarchy between nurse practitioners and physician assistants in one case, by specifying that a minor placed in restraint can only be examined by a PA if a nurse practitioner or physician is unavailable -- again, despite the clinical qualifications of physician assistants equalling those of nurse practitioners. Physician Assistants and Nurse Practitioners are both qualified mid-level professionals. The four thousand Physician Assistants in the Commonwealth could be used to expand access to primary care and lower costs for consumers, and studies have shown that “both PAs and NPs provide healthcare and generate patient outcomes that are mainly the same (to one another and physicians). Moreover, patients see the two professions as largely indistinguishable.” De-elevating physician assistant practice is not only harmful to the thousands of current and future PAs in the Commonwealth, it is harmful to patients seeking access to quality, affordable care.
“We are frustrated by Governor Baker’s failure to include PAs in the bill in their rightful place - as an experienced healthcare practitioner, with training and education on par with a nurse practitioner.” Said Josh Merson, President of MAPA. “While Governor Baker states the desire and need to leverage mid-level practitioners to improve our healthcare system, by ignoring the critical role that PAs can play, his bill does not accomplish this goal.”
We implore the House and Senate to consider the critical role that Physician Assistants already play in primary and preventive care in the Commonwealth - and the expanded role that they can continue to play as deeply qualified mid-level practitioners. MAPA leadership looks forward to working with the members of the House and the Senate to ensure that the final healthcare bill sent to the Governor’s desk does not exclude the thousands of PA’s practicing in the Commonwealth today, many as primary care providers.
 Hooker, Roderick S. and McMichael, Benjamin. Are PAs and NPs Interchangeable? Journal of the American
Academy of PAs. September 2019.