Rural Physician Assistants: Clinical Roles and the Impact on Cost, Quality, and Access
|
|
- Charlene Blankenship
- 8 years ago
- Views:
Transcription
1 Rural Physician Assistants: Clinical Roles and the Impact on Cost, Quality, and Access Christine M. Everett, PhD, MPH, PA-C Assistant Professor Physician Assistant Program Dept. of Community and Family Medicine
2 Objectives What we know (and don t know) about Rural PA Roles Impact of Rural PA Roles Cost Quality Access
3 Rural PA Roles-How do we define them?
4 Defining Rural PA Roles Practice Specialty/Type Most common rural practices are primary care 1,2 Supervision/Physician Involvement Tasks Performed Patient Characteristics Substitution New Conceptualization
5 Defining Roles- Practice Setting-Hospitals 53% of rural hospitals utilize PAs 3 Rural hospital outpatient departments rely heavily on PAs and NPs 4
6 Defining Roles- Primary Care Community Health Centers & Rural Health Clinics 5,6 34% of rural primary care PAs report working in Rural Health Clinics 7
7 Defining Roles- Supervision/Physician Involvement Hours per week in same building with supervising physician 1 Rural : 24.6 Urban: states without mile limits of on-site requirements (December 2013)
8 Defining Roles- Tasks Performed Full range of tasks performed 8 PAs similar to physicians, except 6 : Well-child visits After-hours call coverage Hospital, ED, nursing home coverage Deliveries
9 Roles- Patient Characteristics Rural PAs see similar % Medicare, but greater % Medicaid patients than physicians 7 Age, gender, race/ethnicity of CHC patients seen by PA similar to those seen by physicians 5
10 Defining Roles- Substitution Substitute (Usual Provider) vs. Complement/Supplement Rural PAs report acting as principle provider for higher % of patients than urban PAs (72% vs. 54%) 2 Older adult patients with PA as usual provider more likely to live in rural areas 9 % of visits with usual provider higher for rural PAs 5
11 Patients Differ by Level of Substitution Factors predicting utilization of physician assistant (PA) and advance practice nurses (APN) in different roles (N = 6894) MD PCP + PA/Nurse visit PA or Nurse PCP RRR p-value CI RRR p-value CI Age, years 65 or older Ref ref (1.11,1.8) 2.3 <0.01 (1.56,3.31) (1,1.79) 2.4 <0.01 (1.56,3.66) <= <0.01 (1.59,3.92) Sex Male ref ref Female (1.07,1.51) (1.09,1.75) Educational attainment High school graduate ref ref Less than high school diploma Some college College degree Some postgraduate 1.5 <0.01 (1.16,2.04) County designation Large metropolitan ref ref Small metropolitan (1.02,1.99) Non-metropolitan (1,1.56) 1.7 <0.01 (1.24,2.2) Go to doctor as soon as feel bad Strongly agree ref ref Somewhat agree Somewhat disagree 0.7 <0.01 (0.53,0.88) Strongly disagree Do anything to avoid doctor visit Strongly agree ref ref Somewhat agree Somewhat disagree Strongly disagree 1.6 <0.01 (1.19,2.04) Put off needed medical care (1.05,1.59) (1.08,1.9) See same provider at usual place 0.3 <0.01 (0.19,0.34) Perceived health Excellent ref ref Very Good Good 1.8 <0.01 (1.36,2.36) (0.47,0.97) Fair/Poor 2.5 <0.01 (1.83,3.35)
12 Roles- New Conceptualization How work is divided between clinicians on a team (physician-pa dyad) 10,11,12 Level of Involvement Patients Served Tasks Performed Dependencies between team members Interdependence Autonomy
13 Impact of Rural PAs
14 Cost: Cost of Episodes of Care 13
15 Cost: Economic Benefit of PAs to Family Practice Compensation to production ratio of PA in Family Practice:
16 Cost: Economic Benefit of Rural Primary Care PA to Clinic, Hospital, Community 15 Scenario Collaborative: 40% Patient Volume (clinic + hospital) Collaborative: 50% Patient Volume (clinic + hospital) Collaborative: 75% Patient Volume (clinic + hospital) Independent: 75% Patient Volume (clinic only) Clinic/Hospital Employment Labor Income Clinic/Hospital + Community Employment Community + Labor Income 7.6 $469, $575, $553, $679, $764, $940, $253, $280,476
17 Access and Quality: Hospitalizations for Ambulatory Care-Sensitive Conditions 16 Rural counties have significantly higher rates of ACSH for pediatric and adult populations (not geriatric) Total primary care clinician supply reduces ACSH, but supply of non-physicians (PA/NP) does not
18 Access and Quality: Differences in Reported Access but not Self-Rated Health 9 Compared to those with physicians: Lower perceived access Increased chiropractor visits Decreased complete health exams Decreased mammograms Similar self-rated health Similar difficulties/delays in care
19 Access and Quality: Access to Primary Care, Satisfaction, Utilization Vary by PA/APN Role Variable Healthcare Utilization Physician PCP +PA or Nurse VisitPA or Nurse PCP RRR or RRR or p value CI p value OR OR Number of Visits at Usual Place of Care b <0.01 (0.52,0.83) (0.69,1.27) (1,1.63) 2.4 <0.01 (1.77,3.37) (0.86,1.58) 3.0 <0.01 (2.04,4.53) Emergency Department Visits c (0.78,1.36) (0.67,1.29) <0.01 (1.26,2.47) (0.66,1.87) Hospitalizations c (0.88,1.63) (0.38,1.13) Unmet Need Did not get needed medical care in past 12 months (0.89,1.98) (0.79,2.03) Patient Satisfaction Satisfaction with healthcare a Somewhat satisfied (0.99,1.53) (0.73,1.32) Neither satisfied or dissatisfied (0.88,3.25) (0.82,3.82) Somewhat dissatisfied (0.95,2.96) (0.57,1.66) Very dissatisfied (1.03,3) (0.98,3.04) Reference category is MD only; Baseline category for comparison is: a very satisfied; b 2-4 visits; c zero Bold type indicates significance at p<.05. Controlled to: age, sex, race/ethnicity, education, county designation, income, health insurance, going to doctor as soon as feel bad, do anything to avoid doctor visits, perceived health, utilization (except when dependent variable), usually see same provider, and put off care in past 12 months (and unmet need for satisfaction and utilization) CI
20 Summary PA roles can be defined in a variety of ways Usual provider is a more common role for rural PAs New way to conceptualize roles incorporate multiple factors Primary care PAs have beneficial economic impact on rural areas Limited evidence suggests primary care PAs improve access, but impact on quality is varied
21 References 1. Larson EH, Hart LG, Hummel J. Rural physician assistants: a survey of graduates of MEDEX Northwest. Public Health Rep. Mar-Apr 1994;109(2): Martin KE. A rural-urban comparison of patterns of physician assistant practice. JAAPA. Jul 2000;13(7):49-50, 56, 59 passim. 3. Krein S. The employment and use of nurse practitioners and physician assistants by rural hospitals. J. Rural Health. 1997;13(1): ES H, SU U. Physician Assistant and Advanced Practice Nurse Care in Hospital Outpatient Departments: United States, In: National Center for Health Statistics CfDCaP, US Department of Health and Human Services, ed. Vol NCHS data brief, no.77. Hyattsville, MD: National Center for Health Statistics; Morgan PA, M. EC, Hing E. Nurse practitioners, physician assistants, and physicians in community health centers, Healthcare Ortiz J, Meemon N, Zhou Y, Wan TTH. Trends in rural health Clinics and needs during U.S. health care reform. Prim. Health Care Res. Dev Oct (Epub 2012 Oct 2013;14(4): Doescher M, Andrilla H, Skillman S, Morgan P, Kaplan L. The contributions of physicians, physician assistants and nurse practitioners toward rural primary care: Findings from a 13-state survey. Medical Care. 2014;52: Henry LR, Hooker RS, Yates KL. The Role of Physician Assistants in Rural Health Care: A Systematic Review of the Literature. The Journal of Rural Health. 2011;27(2): Everett CM, Schumacher JR, Wright A, Smith MA. Physician assistants and nurse practitioners as a usual source of care. J Rural Health. Fall 2009;25(4): Everett C, Thorpe C, Carayon P, Palta M, Gilchrist V, Smith M. Division of Primary Care Services Between Physicians, Physician Assistants, and Nurse Practitioners for Older Patients With Diabetes. MCCR (Medical Care Research and Review). 2013;online. 11. Everett C, Thorpe C, Palta M, Carayon P, Bartels C, Smith M. Physician Assistants And Nurse Practitioners Perform Effective Roles On Teams Caring For Medicare Patients With Diabetes. Health Affairs. November 1, ;32(11): Everett C. M., Thorpe C, Carayon P, Palta M, Gilchrist V, MA. S. The roles of primary care PAs and NPs caring for older adults with diabetes. JAAPA. 2014;27(4): Hooker RS. A cost analysis of physician assistants in primary care. JAAPA. Nov 2002;15(11):39-42, 45, 48 passim. 14. Grzybicki DM, Sullivan PJ, Oppy JM, Bethke AM, Raab SS. The economic benefit for family/general medicine practices employing physician assistants. Am J Manag Care. Jul 2002;8(7): Eilrich F, Doeksen G, St. Claire C. Models to estimate the economic impact of a rural Nurse Practitioner or Physician Assistant. National Center for Rural Health Works; August Nayar P, Nguyen AT, Apenteng B, Yu F. Preventable Hospitalizations: Does Rurality or Non- Physician Clinician Supply Matter? Journal of Community Health. Apr 2012;37(2):
Physician Assistant and Advance Practice Nurse Care in Hospital Outpatient Departments: United States, 2008 2009
NCHS Data Brief No. 77 November 0 Physician Assistant and Advance Practice Nurse Care in Hospital Outpatient Departments: United States, 008 009 Esther Hing, M.P.H. and Sayeedha Uddin, M.D., M.P.H. Key
More informationCommunity Health Center Expansion: Roles of Nurse Practitioners and Physician Assistants
Community Health Center Expansion: Roles of Nurse Practitioners and Physician Assistants Perri Morgan, PhD, PA-C Duke University Christine Everett, PhD, PA-C University of Wisconsin-Madison Esther Hing,
More informationWhen I was a new graduate
Jill Curren Nurse Practitioners and Physician Assistants: Do You Know the Difference? Jill Curren, FNP-C, is an OB/GYN Nurse Practitioner, Florida Fertility Institute, St. Petersburg, FL. When I was a
More informationPhysician Assistant & Nurse Practitioner Ambulatory Care & Chronic Disease Management PAEA Annual Conference 2013
Physician Assistant & Nurse Practitioner Ambulatory Care & Chronic Disease Management PAEA Annual Conference 2013 Roderick S. Hooker, PhD, PA, Adjunct Professor, The George Washington University School
More informationPhysician Assistants in the US Health Workforce
Physician Assistants in the US Health Workforce Presented to: National Health Policy Forum November 15, 2013 James F. Cawley, MPH, PA-C, DHL(hon) Professor and Director, PA/MPH Program School of Medicine
More informationIn the mid-1960s, the need for greater patient access to primary care. Physician Assistants in Primary Care: Trends and Characteristics
Physician Assistants in Primary Care: Trends and Characteristics Bettie Coplan, MPAS, PA-C 1 James Cawley, MPH, PA-C 2 James Stoehr, PhD 1 1 Physician Assistant Program, College of Health Sciences, Midwestern
More informationAssessing Rural-Urban Nurse Practitioner Supply and Distribution in 12 States Using Available Data Sources
Policy Brief #143 August 2015 Assessing -Urban Nurse Practitioner Supply and Distribution in 12 States Using Available Data Sources KEY FINDINGS Among 12 study states, estimates of each state s nurse practitioner
More informationSue M. Nyberg, MHS, PA-C Chair and Associate Professor Wichita State University Department of Physician Assistant
Sue M. Nyberg, MHS, PA-C Chair and Associate Professor Wichita State University Department of Physician Assistant First PA students enrolled at Duke University in 1967 Response to shortage and uneven distribution
More informationRecruiting Advanced Practice Providers (APP s) for Hospital and Clinic-based Practices
Exclusively Dedicated to Advanced Practice Providers Locum Tenens Contract to Hire Recruiting Advanced Practice Providers (APP s) for Hospital and Clinic-based Practices Presented by: David McAnally, CPC
More informationNurse Practitioners, Certified Nurse Midwives, and Physician Assistants in Physician Offices
Nurse Practitioners, Certified Nurse Midwives, and Physician Assistants in Physician Offices Melissa Park, M.P.H.; Donald Cherry, M.S.; and Sandra L. Decker, Ph.D. Key findings Data from the National Ambulatory
More informationRoderick S. Hooker, PhD, PA. October 2009 Department of Veterans Affairs Dallas, Texas
Physician Assistant t Collaborative Roles Roderick S. Hooker, PhD, PA October 2009 Department of Veterans Affairs Dallas, Texas Physician Assistants: A Workforce Policy Success? Over 4 decades observation:
More informationState Variability in Supply of Office-based Primary Care Providers: United States, 2012
State Variability in Supply of Office-based Primary Care Providers: United States, 2012 Esther Hing, M.P.H., and Chun-Ju Hsiao, Ph.D. Key findings Data from the National Ambulatory Medical Care Survey
More informationNarrative Description Physician Assistants
Narrative Description Physician Assistant Utilization: Meeting Healthcare Workforce Needs Dawn Ludwig, PhD, PA-C Utilization of physician assistants (Pas) has been a growing workforce issue for Minnesota,
More informationKAPA ISSUE BRIEF Coming Up Short: Kentucky Laws Restrict Deployment of Physician Assistants, and Access to High-Quality Health Care for Kentuckians
KAPA ISSUE BRIEF Coming Up Short: Kentucky Laws Restrict Deployment of Physician Assistants, and Access to High-Quality Health Care for Kentuckians Stephanie Czuhajewski, CAE Issue According to the 2012
More informationWorkforce Series: Physician Assistants
National Rural Health Association Policy Position Workforce Series: Physician Assistants Recruitment and Retention of Quality Health Workforce in Rural Areas: A Series of Policy Papers on the Rural Health
More informationThe Physician Assistant (PA): A historical perspective & Utilizing PAs in the HealthCare Setting
The Physician Assistant (PA): A historical perspective & Utilizing PAs in the HealthCare Setting Randy L. Orsborn, MPAS, PA-C, CLS Physician Assistant Knox Community Hospital Mount Vernon, Ohio Objectives
More informationPatient Satisfaction with Physician Assistant, Nurse Practitioner, and Physician Care: A National Survey of Medicare Beneficiaries
Patient Satisfaction with Physician Assistant, Nurse Practitioner, and Physician Care: A National Survey of Medicare Beneficiaries Roderick S. Hooker, PhD, Daisha J. Cipher, PhD, and Edward Sekscenski,
More informationObstacles to Providing High-Quality Patient Care: Findings from a Survey of Wyoming s Medical Care Providers
Policy Brief Obstacles to Providing High-Quality Patient Care: Findings from a Survey of Wyoming s Medical Care Providers by Davis G. Patterson, PhD Susan M. Skillman, MS Mark P. Doescher, MD, MSPH C.
More informationCenter for Rural Health North Dakota Center for Health Workforce Data. July 2004
North Dakota Nursing Needs Study: Licensed Nurse Survey Year 2 Center for Rural Health North Dakota Center for Health Workforce Data July 2004 Carol Bennett, M.A., R.N. Patricia L. Moulton, Ph.D. Mary
More informationPhysician Assistants. Virginia L. Valentin, MCMS, PA-C Past president of Kentucky Academy of Physician Assistants
Physician Assistants Virginia L. Valentin, MCMS, PA-C Past president of Kentucky Academy of Physician Assistants Objectives At the end of this session the primary care physician should be able to: 1. Summarize
More informationRESEARCH ARTICLE. J Physician Assist Educ 2008;19(2):10-17. 2008 Vol 19 No 2 The Journal of Physician Assistant Education
RESEARCH ARTICLE Perceptions of US Physician Assistants Regarding the Entry-Level Doctoral Degree in PA Education Lindsay S. Ohlemeier, BS; Richard D. Muma, PhD, MPH, PA-C Introduction: Although many health
More informationThe Evolving Role of the Midlevel Providers
The Evolving Role of the Midlevel Providers Sarah Sinclair Executive Chief Nursing Officer Stanley Shalom Zielony Institute for Nursing Excellence May 12, 2011 Overview Healthcare and the economy Workforce
More informationConsidering Adding a NP or PA to the Practice?
Considering Adding a NP or PA to the Practice? Stuart B Black MD, FAAN TNS Medical Economics Chair With the implementation of the Affordable Care Act compounded by the recent multiple changes medicine,
More informationUI College of Nursing. The Need for Nurses Prepared to Address Care Needs of Older Adults in Iowa. Geriatric Nursing. Nursing
The Need for Nurses Prepared to Address Care Needs of Older Adults in Iowa UI College of Nursing #1 in Gerontological nursing in the country! Janet Specht, PhD, RN, FAAN, FGSA Professor and Director John
More informationOFFICE OF FINANCIAL MANAGEMENT. 2012 Washington State Primary Care Nurse Practitioner Survey Data Report
OFFICE OF FINANCIAL MANAGEMENT 2012 Washington State Primary Care Nurse Practitioner Survey Data Report August 2012 Table of Contents Introduction... 1 Select Results from the Survey... 1 About the Survey...
More informationCERTIFIED REGISTERED NURSE ANESTHETISTS IN VERMONT 2013 RE-LICENSURE SURVEY
CERTIFIED REGISTERED NURSE ANESTHETISTS IN VERMONT 2013 RE-LICENSURE SURVEY Prepared by: Mary Val Palumbo DNP, APRN AHEC NURSING WORKFORCE, RESEARCH, PLANNING and DEVELOPMENT University of Vermont 1 PURPOSE
More informationContinuous Quality Improvement using Centricity EMR
Continuous Quality Improvement using Centricity EMR Jamie Howard, MD David A. Nelsen, Jr, MD, MS Associate Professors, UAMS Family & Preventive Medicine Sept 22-25, 2004 CLINICAL INFORMATION SYSTEMS 1
More informationUSE OF HOME HEALTH SERVICES AMONG HIGH-RISK RURAL MEDICARE BENEFICIARIES AND OUTCOMES OF CARE
USE OF HOME HEALTH SERVICES AMONG HIGH-RISK RURAL MEDICARE BENEFICIARIES AND OUTCOMES OF CARE AOTA/AOTF PRE-CONFERENCE INSTITUTE TRACY MROZ, PHD, OTR/L APRIL 6, 2016 BACKGROUND Home health playing increasing
More informationMedicaid Workforce Map Packet
Medicaid Workforce Map Packet Healthcare Workforce Data Center September 2013 Virginia Department of Health Professions Dianne L. Reynolds-Cane, M.D. Director Arne W. Owens Chief Deputy Director HWDC Staff:
More informationPhysician Assistant Workforce: Growing Our Own ND Professionals
Physician Assistant Workforce: Growing Our Own ND Professionals Jeanie McHugo, PhD, PA C Jay Metzger, MPAS, PA C Heidi Olson Fitzgerald, BSN, PA C Objectives Objective 1: At the conclusion of this session,
More informationDaniel Geersen, MPAP, PA-C From Foams to Filters 2010
Daniel Geersen, MPAP, PA-C From Foams to Filters 2010 Topics 1. Nurse Practitioners / Physician Assistants 1. Demographics 2. Professional governance and regulations 3. Education 2. History of the Mid-level
More informationThe Safety Net Landscape: An Evolving World. Leighton Ku, PhD, MPH Professor & Director Center for Health Policy Research Leighton.ku@gwumc.
The Safety Net Landscape: An Evolving World Leighton Ku, PhD, MPH Professor & Director Center for Health Policy Research Leighton.ku@gwumc.edu 1 Two Health Safety Nets Insurance Safety Net: Medicaid, CHIP,
More informationAcademic Degrees and Clinical Practice Characteristics: The University of Washington Physician Assistant Program: 1969-2000
Academic Degrees and Clinical Practice Characteristics: The University of Washington Physician Assistant Program: 1969-2000 Timothy C. Evans, MD, PhD ; 1,2 Keren H. Wick, PhD ; 2 Douglas M. Brock, PhD
More informationMichigan Department of Community Health Survey of Physician Assistants Frequency Report by School 1
Michigan Department of Community Health Survey of Physician Assistants Frequency Report by School 1 INTRODUCTION Since 2007, the Michigan Department of Community Health (MDCH) has conducted annual surveys
More informationPhysician Assistants: Partners in the Practice of Medicine
Career Pulse Physician Assistants: Partners in the Practice of Medicine Patrick Knott, MS, PA-C Dawn LaBarbera, MS, PA-C Physician assistants (PAs) are health care professionals licensed to practice medicine
More informationPhysician-led health care teams
Physician-led health care teams New health care delivery system reforms hinge on a team-based approach to care. With seven years or more of postgraduate education and thousands of hours of clinical experience,
More informationR H W. October 2013 Research Study
National Center for Rural Health Works www.ruralhealthworks.org October 2013 Research Study The Economic Impact of a Rural Primary Care Physician Fred C. Eilrich, Gerald A. Doeksen, and Cheryl F. St. Clair,
More informationWho are most likely to visit hospital emergency departments (EDs)?
Research Brief The Methodist Le Bonheur Center for Healthcare Economics July 2015 Visitors to Hospital Emergency Rooms: Who, Why, and How Much Do They Cost? Cyril F. Chang, Ph.D. Introduction Hospital
More informationCenter for Health Information & Research
Developments in Arizona Rural Health: Health Information Technology 40th Annual Arizona Rural Health Conference The Evolution of Rural Health. August 20, 2013 Center for Health Information & Research Physician
More informationThe relationship between insurance coverage and access to a regular source of health care
The relationship between insurance coverage and access to a regular source of health care The relationship between insurance status and access to and use of health care services has been established in
More informationHow To Identify A Nurse Practitioner
How Many Nurse Practitioners in Primary Care? There are significant differences depending on how you count them Erin Fraher, PhD MPP with Yin Li, BM RN Program on Health Workforce Research & Policy Cecil
More informationRural Disparities in posthospitalization. after traumatic brain injury.
Rural Disparities in posthospitalization rehabilitation after traumatic brain injury. Ashley D Meagher MD, Jennifer Doorey MS, Christopher Beadles MD PhD, Anthony Charles MD MPH University of North Carolina
More informationHow to Prepare Physician Assistants For a Career in Indiana
COMMISSION FOR HIGHER EDUCATION Friday, February 12, 2010 DECISION ITEM A-2: Master of Science in Physician Assistant Studies To Be Offered by Indiana State University at Terre Haute Staff Recommendation
More informationIncreased Role of NPs and PAs in your Practice. Kim R. Montee, MD Bonnie Hayslett, PA-C
Increased Role of NPs and PAs in your Practice Kim R. Montee, MD Bonnie Hayslett, PA-C Kim R. Montee, M.D. Experience before medical school Training in Klamath Falls FNP experience in training FNP/PA in
More informationPHYSICIAN ASSISTANTS TRANSFORMING HEALTH CARE
PHYSICIAN ASSISTANTS TRANSFORMING HEALTH CARE December 2010 WHAT IS A PA? What is a PA? A physician assistant (PA) is a graduate of an accredited PA educational program who is authorized by the state to
More informationThe Role of Physician Assistants in Rural Health Care: A Systematic Review of the Literature
ORIGINAL ARTICLE The Role of Physician Assistants in Rural Health Care: A Systematic Review of the Literature Lisa R. Henry, PhD; 1 Roderick S. Hooker, PhD, PA; 2 & Kathryn L. Yates, BA 1 1 Anthropology
More information2015 Washington State. Advanced Registered Nurse Practitioner Survey. Data Report
1 2015 Washington State Advanced Registered Nurse Practitioner Survey Data Report Sponsored by the Washington State Nurses Association and Washington Center for Nursing The study was funded in part by
More informationADVANCED PRACTICE CLINICIAN PAY WHAT'S HAPPENING AND WHAT'S COMING
ADVANCED PRACTICE CLINICIAN PAY WHAT'S HAPPENING AND WHAT'S COMING 2012, SULLIVAN, COTTER AND ASSOCIATES, INC. As health care organizations prepare to respond to physician shortages and a shift to outcomes
More informationSupport for Rural Recruitment and Practice among U.S. Nurse Practitioner Education Programs
Policy Brief #147 May 2014 Support for Rural Recruitment and Practice among U.S. Nurse Practitioner Education Programs Key Findings Preparing nurse practitioners (NPs) for practice in rural areas was very
More informationNational Quality Management
National Quality Management National Approval Date: Effective Date: 02/24/2015 Subject Practitioner and Provider Availability: Network Composition and Contracting Plan Originating Dept. National Quality
More informationVIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS Report to the Joint Commission On Health Care The Advisability of Establishing a MidLevel Provider License 7/1/2015 Executive Summary In response to House Joint
More informationTREND WHITE PAPER LOCUM TENENS NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS: A GROWING ROLE IN A CHANGING WORKFORCE
TREND WHITE PAPER LOCUM TENENS NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS: A GROWING ROLE IN A CHANGING WORKFORCE The Leader in Locum Tenens Staffing INTRODUCTION Today s Mobile Healthcare Work Force
More informationAccess to Care: Primary Care Physicians Per 1,000 Pop.
Access to Care: Primary Care Physicians Per 1,000 Pop. From 2010 to 2013 the number of physicians in Arkansas grew 2% per year. Physician growth rate differed greatly by county Median County Physician
More information2015 National Conference on Health Statistics. Ellen Kurtzman, M.P.H., R.N., FAAN 2014 NCHS/AcademyHealth Health Policy Fellow
2015 National Conference on Health Statistics Ellen Kurtzman, M.P.H., R.N., FAAN 2014 NCHS/AcademyHealth Health Policy Fellow Agenda The nurse practitioner (NP) landscape What roles do NPs play in the
More informationDemographic, Education, and Practice Characteristics of Advanced Registered Nurse Practitioners in Washington State: Results of a 2008 Survey
Final Report #124 Demographic, Education, and Practice Characteristics of Advanced Registered Nurse Practitioners in Washington State: Results of a 2008 Survey April 2009 by Susan M. Skillman, MS C. Holly
More informationWhich Physician Assistant Training Programs Produce Rural PAs? A National Study
Policy Brief #154 February 2016 Which Physician Assistant Training Programs KEY FINDINGS Rural PA production is concentrated in a small number of programs. From 2000 through 2012, 10% of PA programs produced
More informationTEXAS ACADEMY OF PHYSICIAN ASSISTANTS
TEXAS ACADEMY OF PHYSICIAN ASSISTANTS TAPA TEXAS ACADEMY OF PHYSICIAN ASSISTANTS TAPA was established as a non-profit organization in February 1975 PAs function in team-based care with physicians as provided
More information2010 Pulse of Pennsylvania s Physician and Physician Assistant Workforce. Bureau of Health Planning
2010 Pulse of Pennsylvania s Physician and Physician Assistant Workforce Bureau of Health Planning A Report on the 2010 Surveys of Physicians and Physician Assistants Volume 4, June 2012 TABLE OF CONTENTS
More informationThe Emergency Care Workforce in the U.S. August 2006
The Emergency Care Workforce in the U.S. August 2006 Prepared by the Center for Health Workforce Studies by Sandra McGinnis Jean Moore David Armstrong EXECUTIVE SUMMARY Emergency care systems in the United
More informationCommunity Health Centers: Workforce and Access Issues
Community Health Centers: Workforce and Access Issues Local Perspective Family Health Centers, Inc. Louisville, KY Federally Qualified Health Center 20 FQHC grantees in Kentucky (4 urban) 1200 FQHCs Nationally
More informationTHE U.S. HEALTH WORKFORCE CHARTBOOK. Part II: Clinicians and Health Administration
THE U.S. HEALTH WORKFORCE CHARTBOOK Part II: Clinicians and Health Administration U.S. Department of Health and Human Services Health Resources and Services Administration National Center for Health Workforce
More informationBilling for Non-Physician Practitioners
Billing for Non-Physician Practitioners Incident to and Shared Services 2007 Betsy Nicoletti 1 Betsy Nicoletti www.mpconsulting.org Author: 2007 Physician Auditing Workbook The Field Guide to Physician
More informationAppendix IX. Nurse Practitioners and Physician Assistants (Initiative Memorandum) APRIL 2013
Appendix IX. Nurse Practitioners and Physician Assistants (Initiative Memorandum) APRIL 2013 http://berkeleyhealthcareforum.berkeley.edu 1 Appendix IX: Nurse Practitioners and Physician Assistants (Initiative
More informationPractice Patterns and Characteristics of Nurse Practitioners in Washington State
Working Paper #109 Practice Patterns and Characteristics of Nurse Practitioners in Washington State March 2007 by C. Holly A. Andrilla, MS L. Gary Hart, PhD Louise Kaplan, PhD, ARNP Marie-Annette Brown,
More informationHealth Professions Data Series Registered Nurses 2010
Executive Office of Health and Human Services Health Professions Data Series Registered Nurses 2010 Deval L. Patrick, Governor Timothy P. Murray, Lieutenant Governor John W. Polanowicz, Secretary Lauren
More informationTiara B. Shoter, J.D. Boehl Stopher & Graves, LLP tshoter@bsg-law.com. The Physician Shortage Crisis & The Use of Allied Healthcare Providers
Tiara B. Shoter, J.D. Boehl Stopher & Graves, LLP tshoter@bsg-law.com The Physician Shortage Crisis & The Use of Allied Healthcare Providers Legal Disclosure Tiara B. Shoter has no relevant financial relationships
More information2009 Emergency Physician Salary & Benefit Survey THIS REPORT: U.S. NATIONAL RESULTS
2009 Emergency Physician Salary & Benefit Survey THIS REPORT: U.S. TIOL RESULTS 2009 Emergency Physician Salary & Benefit Survey THIS REPORT: U.S. TIOL RESULTS About the Survey Daniel Stern and Associates
More informationHealth Economics Program
Health Economics Program Issue Brief 2006-05 August 2006 Medicare Supplemental Coverage and Prescription Drug Use, 2004 Medicare is a federal health insurance program that provides coverage for the elderly
More informationMarch 17, 2015. The Honorable Jerry Moran U.S. Senate 361A Russell Senate Office Building Washington, DC 20510. Dear Senator Moran:
March 17, 2015 The Honorable Jerry Moran U.S. Senate 361A Russell Senate Office Building Washington, DC 20510 Dear Senator Moran: On behalf of the 42 undersigned organizations representing the Nursing
More informationHighlights From the 2012 National Sample Survey of Nurse Practitioners
Highlights From the 2012 National Sample Survey of Nurse Practitioners Health Resources and Services Administration Bureau of Health Professions National Center for Health Workforce Analysis The Health
More informationADVANCED PRACTICE PROVIDERS IN ACADEMIC NEUROLOGY PRACTICE
ADVANCED PRACTICE PROVIDERS IN ACADEMIC NEUROLOGY PRACTICE Gretchen E. Tietjen, MD Clair Martig Chair and Distinguished Professor Department of Neurology University of Toledo The Workforce Task Force Report
More informationUpdating Rheumatology Skills in Primary Care: The Maine Arthritis Partnership (MAP) Program
Updating Rheumatology Skills in Primary Care: The Maine Arthritis Partnership (MAP) Program Advisory Board Jacqueline B. Cawley, DO; Sr. Director for Ambulatory Care and Preventive Health, MaineHealth
More informationOnline Use Only. Do Not Reprint. BROADENING THE SCOPE of primary
EXECUTIVE SUMMARY Bending the cost curve for health care services in the United States challenges policymakers. A cost analysis was undertaken based on what would occur if more physician assistants (PAs)
More informationMedical Billing Trends in the United States
Occupational Medicine 2004;54:153 158 DOI: 10.1093/occmed/kqg126 Physician assistants in occupational medicine: how do they compare to occupational physicians? R. S. Hooker Background Physician assistants
More informationCERTIFIED NURSE MIDWIVES IN VERMONT 2013 RE-LICENSURE SURVEY
CERTIFIED NURSE MIDWIVES IN VERMONT 2013 RE-LICENSURE SURVEY Prepared by: Mary Val Palumbo DNP, APRN AHEC NURSING WORKFORCE, RESEARCH, PLANNING and DEVELOPMENT University of Vermont 1 PURPOSE The UVM Area
More informationDOES THE EMPLOYMENT OF PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS INCREASE LIABILITY?
DOES THE EMPLOYMENT OF PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS INCREASE LIABILITY? Roderick S. Hooker, Ph.D., PA, Jeffrey G. Nicholson, Ph.D., PA, Tuan Le, M.D., DrPH ABSTRACT We assessed whether
More informationCalifornia Board of Registered Nursing
California Board of Registered Nursing 2006 Survey of Registered Nurses Conducted for the California Board of Registered Nursing by the University of California, San Francisco School of Nursing and Center
More informationSTATISTICAL BRIEF #383
STATISTICAL BRIEF #383 August 212 Preventive Health Care Utilization by Adult Residents of s and non-s: Differences by Race/Ethnicity, 29 Julia Caldwell, MPH and Jim Kirby, PhD Introduction Healthy People
More informationSurvey of Nurse Practitioners: Practice Trends and Perspectives
Survey of Nurse Practitioners: Practice Trends and Perspectives Advanced Practice An Examination of the Professional Morale, Practice Patterns, Career Plans, and Perspectives of Nurse Practitioners Attending
More informationTexas Diabetes Fact Sheet
I. Adult Prediabetes Prevalence, 2009 According to the 2009 Behavioral Risk Factor Surveillance System (BRFSS) survey, 984,142 persons aged eighteen years and older in Texas (5.4% of this age group) have
More informationMedicare Supplemental Coverage in Minnesota
Medicare Supplemental Coverage in Minnesota December 2002 h ealth e conomics p rogram Health Policy and Systems Compliance Division Minnesota Department of Health Medicare Supplemental Coverage in Minnesota
More informationPhysician Assistant Education Training Model (PAETM): Addressing the PA educator shortage
Physician Assistant Education Training Model (PAETM): Addressing the PA educator shortage Miranda Collins, MEd, MPAS, PA-C Marietta College Program Director William A. Childers Jr., EdD, MS, PA-C West
More informationNational Findings on Access to Health Care and Service Use for Non-elderly Adults Enrolled in Medicaid
National Findings on Access to Health Care and Service Use for Non-elderly Adults Enrolled in Medicaid By Sharon K. Long Karen Stockley Elaine Grimm Christine Coyer Urban Institute MACPAC Contractor Report
More informationLessons for Primary Care Workforce Development: Growing the PA Profession Around the World
Lessons for Primary Care Workforce Development: Growing the PA Profession Around the World Ruth Ballweg MPA, PA-C Professor and Senior Advisor February 2015 Learning objectives At the end of this activity
More informationMedia Packet 10-2009. NPAM@npedu.com 888-405-NPAM. PO Box 540 Ellicott City, MD 21041
Media Packet What is a Nurse Practitioner NP Facts Who are the Nurse Practitioners in Maryland State of the State Quality of NP Practice NP Cost Effectiveness 10-2009 NPAM@npedu.com 888-405-NPAM PO Box
More informationElisa Iezzi* Matteo Lippi Bruni** Cristina Ugolini**
24-25 June 2010 Elisa Iezzi* Matteo Lippi Bruni** Cristina Ugolini** elisa.iezzi@unibo.it matteo.lippibruni2@unibo.it cristina.ugolini@unibo.it * Department of Statistics, University of Bologna **Department
More informationThe Promise and Potential of Federal Incentives for Electronic Health Records
The Promise and Potential of Federal Incentives for Electronic Health Records Brian Bruen, 1 Leighton Ku, 1 Matthew Burke, 2 and Melinda Buntin 2 1 George Washington University 2 Office of the National
More informationof the Nurse Practitioner
The Emerging Role of the Nurse Practitioner Rhonda Hettinger DNP, NP C, CLS Introduction The American health care system is in need of a fundamental change (Institute t of Medicine, 2001). Nurse practitioner
More informationWINGATE UNIVERSITY. Harris Department of Physician Assistant Studies
WINGATE UNIVERSITY Harris Department of Physician Assistant Studies WINGATE UNIVERSITY Harris Department of Physician Assistant Studies Inaugural class admitted 2008; graduated 2010 Accredited by ARC-PA
More information2013 Survey of registered nurses
We ve earned The Joint Commission s Gold Seal of Approval 2013 Survey of registered nurses Generation Gap Grows as Healthcare Transforms AMN Healthcare, Inc., 2013 12400 High Bluff Drive, San Diego, CA
More informationHow To Write A Recipe Card
Collaborative Practice by Nurse Practitioners and Physicians in Long-Term Care Facilities: A Mixed-Methods Study Faith Donald and Alba DiCenso McMaster University Nurse Practitioner Survey Collaboration
More informationTHE U.S. HEALTH WORKFORCE CHARTBOOK. Part IV: Behavioral and Allied Health
THE U.S. HEALTH WORKFORCE CHARTBOOK Part IV: Behavioral and Allied Health U.S. Department of Health and Human Services Health Resources and Services Administration National Center for Health Workforce
More informationRural Residency Training for Family Medicine Physicians: Graduate Early-Career Outcomes, 2008-2012
http://www.raconline.org/rtt Policy Brief January 2013 Rural Residency Training for Family Medicine Physicians: Graduate Early-Career Outcomes, 2008-2012 This policy brief updates a previous one 1 with
More informationPreparing for Therapy Required Functional Reporting Implementation in CY 2013
Preparing for Therapy Required Functional Reporting National Provider Call December 12, 2012 1:30-3pm ET Presented by: Pamela R. West, DPT, MPH Centers for Medicare & Medicaid Services, Center for Medicare
More informationSue Flocke, PhD Eileen L. Seeholzer, MD MS Heidi Gullett, MD MPH
Sue Flocke, PhD Eileen L. Seeholzer, MD MS Heidi Gullett, MD MPH Brigid Jackson, MA Samantha Smith, MA Elizabeth Antognoli, PhD Sue Krejci, MBA Peter J. Lawson, MA MPH MBA Practice-based Research Network
More informationMedical Billing and Meaningful Use of EHR
Meaningful Use of EHR Technology GA-HIT Regional Extension Center (GA-HITREC) Dominic H. Mack MD, MBA Project Director, GA-HITREC Deputy Director, National Center for Primary Care Morehouse School of Medicine
More informationFamily Physicians and Physician Assistants: Team-Based Family Medicine
Family Physicians and Physician Assistants: Team-Based Family Medicine A Joint Policy Statement of the American Academy of Family Physicians and American Academy of Physician Assistants February 2011 The
More informationHow To Understand And Understand The Health Care Needs In North Dakota
North Dakota Nursing Needs Study 2011 Licensed Nurse Supply Analysis January, 2012 Patricia L. Moulton, Ph.D. North Dakota Center for Nursing Research Publication #3 Funding for this project was provided
More informationWashington State s Practicing Physician Workforce Capacity and Characteristics WASHINGTON STATE HEALTH SERVICES RESEARCH PROJECT
WASHINGTON STATE OFFICE OF FINANCIAL MANAGEMENT WASHINGTON STATE HEALTH SERVICES RESEARCH PROJECT Research Brief No. 058 December 2010 Washington State s Practicing Physician Workforce Capacity and Characteristics
More information