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 at master’s degree level ❑ Licensed by North Carolina Medical Board. ❑ Include more than 2,000 hours of ❑ Initial certification required by NC law. clinical training ❑ Maintenance of certification not ❑ Trained as medical generalists in the required but 97% maintain certification medical model but have the ability to in NC practice in every specialty and subspecialty with proper training. ❑ Maintain both through CME ❑ Certification also requires 10 year comprehensive exam. 2
Working with PAs PAs are PAs are widely team trusted players PAs PAs connect connect with patients with each other 3
We’ve Come a Long Way 1967 2019 Three former Navy Over 7,000 PAs practice corpsmen graduate from in every medical Duke University PA program specialty and clinical setting in North Carolina 4
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 5
Updating PA Practice Laws and Policies 6 Key Elements in State PA Law 6
Updating PA Practice Laws and Policies Reasons to move beyond Six Key Elements of Current PA Practice: Verdict is in: Dynamic changes PAs provide high quality care in healthcare marketplace Many early PA laws outdated 7
Changing Healthcare Marketplace 8
Changing Healthcare Marketplace Laws in Many States Do Not Require NPs to Have Supervising Agreements Number of States Where NPs Have Full Practice Authority by Year 9
Changing Healthcare Marketplace 10
OTP In North Carolina To implement new policy, NCAPA is considering how to change laws and regulations to: 2 1 4 3 Credential PAs with Team-based care is Modernize Medical Increase PA representation in the all insurers so that best practice. Practice Act to regulation of PA PAs are eligible for remove obsolete practice in NC. reimbursement for requirements and all medical move supervisory services provided. arrangements to the practice level. 11
OTP: What NC PAs Think 12
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 13
Replacing Supervisory Agreement Laws Optimal Team Practice is an evolution of the profession and better reflects real life practice. 14
Potential Benefits to Physicians PAs are completely No disciplinary action for “paperwork responsible for the infractions” care they provide Accuracy of data Eliminating physician related to quality and liability for care value of care provided provided by PAs by PAs Reducing PA skills are portable administrative and not tied to other burdens and provider’s skills increased flexibility 15
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 16
Direct Reimbursement PAs are the only health professionals PAs must have the who bill Medicare same reimbursement that are not entitled to direct flexibility as other reimbursement. health professionals in order to maximize PA practice. 17
Vision for the Future o Eliminate requirement to register collaborative physician on intent to practice form. o PA scope of practice including supervisory arrangements described and maintained at practice level. o The PA is responsible for his/her own medical acts and is expected to seek clinical input and make referrals when needed. 18
Vision for the Future o PAs individual competency and acquired skills should be portable. o PAs should bill and be reimbursed under their own NPI number. o PAs want to continue to be licensed by and have representation on the NC Medical Board. 19
Vision for the Future o PAs wish to preserve all hard won privileges we currently enjoy. o PAs do not want to be bargaining chips in any conversation about the scope of practice of other medical providers. o We wish to be included in any and all conversations about PA Practice and the future of PA practice in North Carolina. 20
THANK YOU Questions? 21
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