Fiscal contributions of physician assistants to family medicine practices
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The Affordable Care Act (ACA) was passed by Congress in 2010 as a health policy initiative to improve the effectiveness of the United States healthcare system. Policies and regulations under the ACA include provisions to improve the quality and cost-effectiveness of medical services which has resulted in a transition of payment systems from fee-for-service (FFS) reimbursement models to value-based reimbursement (VBR) models. Policies under the ACA also encouraged the formation of affordable care organizations (ACOs) which endorse new models of healthcare delivery, specifically team-based care models, to increase the efficiency, quality and accessibility of medical care while at the same time controlling costs. Although physician assistants (PAs) have been a proposed method for addressing the growing demand for high quality, cost-effective healthcare, research that explores the economic value and financial impact of physician assistants is limited. Currently, productivity metrics are used to determine the economic value of physicians and PAs. Current methods of measuring productivity include volume-based metrics and claim based data. Although these methods may be sufficient for measuring physician productivity, they fail to account for PA practices. Current productivity metrics also fail to account for a vast majority of PA productivity due to current billing policies that do not capture all services provided by PAs. In this study, we will explore the financial impact associated with the addition of PAs to ten different physician-owned family medicine practices by measuring the percent increase in net annual practice revenue one year after the employment of a PA. Net practice revenue is defined as the total revenue generated per provider per year minus overhead costs associated with provider employment.