PAs and Optimal Team Practice Josh Smith, NCAPA President Truett - - PowerPoint PPT Presentation

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PAs and Optimal Team Practice Josh Smith, NCAPA President Truett - - PowerPoint PPT Presentation

PAs and Optimal Team Practice Josh Smith, NCAPA President Truett Smith, OTP Taskforce Chair Marc Katz, Government Affairs Chair Emily Adams, Executive Director 1 Understanding PA Practice PA Training Licensure and Certification Educated


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PAs and Optimal Team Practice

Josh Smith, NCAPA President Truett Smith, OTP Taskforce Chair Marc Katz, Government Affairs Chair Emily Adams, Executive Director

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Understanding PA Practice

PA Training

❑ Educated at master’s degree level ❑ Include more than 2,000 hours of clinical training ❑ Trained as medical generalists in the medical model but have the ability to practice in every specialty and subspecialty with proper training.

Licensure and Certification

❑ Licensed by North Carolina Medical Board. ❑ Initial certification required by NC law. ❑ Maintenance of certification not required but 97% maintain certification in NC ❑ Maintain both through CME ❑ Certification also requires 10 year comprehensive exam.

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Working with PAs

PAs are widely trusted PAs are team players PAs connect with patients PAs connect with each

  • ther
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We’ve Come a Long Way

Three former Navy corpsmen graduate from Duke University PA program

1967

Over 7,000 PAs practice in every medical specialty and clinical setting in North Carolina

2019

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Optimal TEAM Practice

  • Focuses on healthcare teams and patient

safety.

  • OTP recognizes PAs training, skills and

competency and responsibility for care they provide

  • OTP eliminates specific supervisory agreements

to avoid disparities and unfair advantages held by other professions

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Updating PA Practice Laws and Policies

6 Key Elements in State PA Law

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Reasons to move beyond Six Key Elements of Current PA Practice:

Updating PA Practice Laws and Policies

Verdict is in: PAs provide high quality care Dynamic changes in healthcare marketplace Many early PA laws outdated

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Changing Healthcare Marketplace

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Changing Healthcare Marketplace

Number of States Where NPs Have Full Practice Authority by Year

Laws in Many States Do Not Require NPs to Have Supervising Agreements

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Changing Healthcare Marketplace

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Team-based care is best practice.

OTP In North Carolina

To implement new policy, NCAPA is considering how to change laws and regulations to:

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Modernize Medical Practice Act to remove obsolete requirements and move supervisory arrangements to the practice level. Credential PAs with all insurers so that PAs are eligible for reimbursement for all medical services provided.

Increase PA representation in the regulation of PA practice in NC.

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OTP: What NC PAs Think

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Replacing Supervisory Agreement Laws

PAs seeking OTP does not mean that PAs want to practice independently. Optimal Team Practice is about team based practice and includes two important points that distinguish it from independent practice:

  • It reinforces PAs’ commitment to team practice
  • Calls for collaboration decisions to be made at the

practice level

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Replacing Supervisory Agreement Laws

Optimal Team Practice is an evolution of the profession and better reflects real life practice.

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Potential Benefits to Physicians

Reducing administrative burdens and increased flexibility Eliminating physician liability for care provided by PAs No disciplinary action for “paperwork infractions” Accuracy of data related to quality and value of care provided by PAs PAs are completely responsible for the care they provide PA skills are portable and not tied to other provider’s skills

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Benefits to Patients

  • Expand access to care
  • Increase volunteer medical services
  • Physician focus on more complex patient needs
  • Add efficiency and value to health systems
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PAs are the only health professionals who bill Medicare that are not entitled to direct reimbursement.

Direct Reimbursement

PAs must have the same reimbursement flexibility as other health professionals in order to maximize PA practice.

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Vision for the Future

  • Eliminate requirement to register collaborative

physician on intent to practice form.

  • PA scope of practice including supervisory

arrangements described and maintained at practice level.

  • The PA is responsible for his/her own medical acts and

is expected to seek clinical input and make referrals when needed.

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Vision for the Future

  • PAs individual competency and acquired skills

should be portable.

  • PAs should bill and be reimbursed under their
  • wn NPI number.
  • PAs want to continue to be licensed by and have

representation on the NC Medical Board.

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Vision for the Future

  • PAs wish to preserve all hard won privileges we

currently enjoy.

  • PAs do not want to be bargaining chips in any

conversation about the scope of practice of other medical providers.

  • We wish to be included in any and all conversations

about PA Practice and the future of PA practice in North Carolina.

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THANK YOU

Questions?