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PA reimbursement for Washington L&I


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https://content.govdelivery.com/accounts/WADLI/bulletins/3b38145

Some background: PAs and NPs were paid a fraction of physician reimbursement, but about 2016-17ish, NPs were upscaled to 100% of physician pay while PAs have been left at 90% since. It's actually a little bit more nuanced than that, because some things (e.g., clinical phone calls) have a physician and non-physician rate: Physicians get 100% of physician rate, NPs 100% of non-physician rate, and PAs 90% of the non-physician rate.

I absolutely have a financial interest in this being adopted: me and the one other PA I retain as a 1099 contractor would get paid thousands of dollars more per year for doing the exact same work.

Edited by rev ronin
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37 minutes ago, alvll said:

How can we help? 

If you're in Washington state, follow the link and provide email testimony in support of the repeal. That is, the proposed regulation repeals the 90% set point for PAs, so we're in favor of it, because if it goes away, we get paid normal rates like everyone else.

Some of my talking points might be:

* PAs are at least as well trained and provide at least as good of care for injured workers as NPs do.
* By Incentivizing Washington PAs to care for L&I patients, the move will increase access to care. I turned away 3 new patient inquiries in the past week--injured workers are languishing without care, and Occ Med practices won't hire PAs because they don't make as much off of a PA as an NP.
* PAs are some of the best attending providers for injured workers. We have an optimum combination of patient communication, medical knowledge, and efficiency. When the patient needs a specialist, we refer them to one... but we're generalist resources. I tell my patients "You don't want me doing your shoulder surgery... and you shouldn't want your orthopedist doing your paperwork!" Not that an orthopedic surgeon can't write a good activity prescription form, but it's not them practicing at the top of their license, either.
* PAs are trained in the medical team model, so working with psych, ortho, PT/MT, vocational counselors, etc. comes naturally to us. We're not trained to be lone rangers; even though I have my own medical practice, it is part of an integrated referral ecosystem.
* Primary Care PAs are able to provide incidental care to injured workers that keeps things moving smoothly, quality-of-life things that cost the State nothing yet increase injured workers' quality of life.
* Since so many of us have non-medical prior work experience, we have a better foundational grounding in what work is and is not, and also tend to have a better fakery detector.

But that's just my perspective.

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