Cost effective

[pvdude]

I brought up in an interview that pas are cost effective and the interviewer told me that a pa visit is the same as an md visit...i thought pas build at 85%the of the rate?

[physasst]

I brought up in an interview that pas are cost effective and the interviewer told me that a pa visit is the same as an md visit...i thought pas build at 85%the of the rate?

 

 

Depends on the payor. Also, there is no billing at 85%.....ALL billing is the same for professional services....Medicare/Medicaid and BC/BS reimburse at 85%....Aetna in Tennessee does as well I think....All others reimburse at 100%.

[pvdude]

Build? Really? Ok so the reimbursement is 85%. Got it. Thanks.

[sartort]

My understanding is this (and I haven't started PA school yet, so take it with a grain of salt):

 

Some payers will reimburse at a lower rate, as previously mentioned. In some cases even Medicare will be expected to reimburse at 100% depending on the service provided. I think you are still 100% correct in that the PA profession overall lowers the cost of healthcare, and when I brought this up in an interview at Yale I just got smiles, nods and "oh yeah"'s rather than an argument in return. Because PAs are paid less than physicians it makes sense that the overall cost of healthcare is lowered due to the profession (the basis of the profession and the Affordable Care Act push for PA education both seem to support this idea). I highly doubt that the doctors just make more, or some administrator just makes more because PAs make less, and therefore I think the visits cost the same for the patients but they would cost everyone more if everyone was paid at an MD/DO salary. Make sense?

 

I would definitely not say that they are cost effective for the patient specifically, as in a patient who prefers a PA will likely not pay any less, but they definitely seem to be cost effective for the nation as a whole. Also, the federal government subsidizes residencies (I believe mostly through Medicare) making it cost-effective for the taxpayer to have someone practice who did not have to attend a residency. I believe this contributes, in part, to the bottle-neck problem of entering the MD profession. I have heard a person who works in medical billing make the argument that PAs don't save us (the country) a cent, but these were following complaints about the Affordable Care Act not increasing the number of physicians, to which I added that it does increase the number of PAs.

 

Regarding your interview, I hope you didn't stumble too much. They may have just wanted more clarification and I think it's reasonable that most applicants (myself included) will not have a lot of information about the billing process and business aspects of practicing medicine. I have actually considered that to be my answer if I had ever been asked about the weak points in my application.

[Gordon, PA-C]

The NPs have several studies supposedly proving they are more cost-effective than physicians. I am not aware of any studies being done with regard to PAs in that matter. It would be a harder to avoid confounders, since the NPs are "independent" and we're not.