Administrator rev ronin Posted May 10, 2013 Author Administrator Share Posted May 10, 2013 As part of the effort to retool Group Health's affordability in preparation for Obamacare, it was announced this week that the ratio of physicians to advance practice providers would be moving from 5:1 to 3:2 in the future. These APPs (PAs/ARNPs) will also be primary care providers of record. That, my friends, is HUGE. PAs are already members of the medical staff here, and whatever problems Group Health (as a health plan) may have had with jmj11 as a practice owner, Group Health (as a medical delivery organization) sees the way to provide care to more at an affordable price point is to use us in lieu of physicians, and adjust the practitioner mix so APPs handle the not-so-complex cases, both in primary and specialist care. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 10, 2013 Administrator Share Posted May 10, 2013 As part of the effort to retool Group Health's affordability in preparation for Obamacare, it was announced this week that the ratio of physicians to advance practice providers would be moving from 5:1 to 3:2 in the future. These APPs (PAs/ARNPs) will also be primary care providers of record. That, my friends, is HUGE. PAs are already members of the medical staff here, and whatever problems Group Health (as a health plan) may have had with jmj11 as a practice owner, Group Health (as a medical delivery organization) sees the way to provide care to more at an affordable price point is to use us in lieu of physicians, and adjust the practitioner mix so APPs handle the not-so-complex cases, both in primary and specialist care. Link to comment Share on other sites More sharing options...
SoCal_PA Posted May 10, 2013 Share Posted May 10, 2013 More information on this PLEASE!! Also, what immediate implications do you think this will this have for PAs? Link to comment Share on other sites More sharing options...
SoCal_PA Posted May 10, 2013 Share Posted May 10, 2013 More information on this PLEASE!! Also, what immediate implications do you think this will this have for PAs? Link to comment Share on other sites More sharing options...
Just Steve Posted May 10, 2013 Share Posted May 10, 2013 We were just talking about the recent increase in PA job listings for them in the greater Seattle area today. Link to comment Share on other sites More sharing options...
Just Steve Posted May 10, 2013 Share Posted May 10, 2013 We were just talking about the recent increase in PA job listings for them in the greater Seattle area today. Link to comment Share on other sites More sharing options...
SocialMedicine Posted May 10, 2013 Share Posted May 10, 2013 aren't most places increasing the ratio and hiring more PA type providers in the interest of money ? Link to comment Share on other sites More sharing options...
SocialMedicine Posted May 10, 2013 Share Posted May 10, 2013 aren't most places increasing the ratio and hiring more PA type providers in the interest of money ? Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 10, 2013 Author Administrator Share Posted May 10, 2013 aren't most places increasing the ratio and hiring more PA type providers in the interest of money ? Reimbursed at 85%, paid at 50% (or less), what's not to like about PAs? It's not the docs who will be the greatest advocates for our profession... it will be the hospital and health plan administrators, who won't want to pay for a Cadillac solution to a Ford problem. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 10, 2013 Author Administrator Share Posted May 10, 2013 aren't most places increasing the ratio and hiring more PA type providers in the interest of money ? Reimbursed at 85%, paid at 50% (or less), what's not to like about PAs? It's not the docs who will be the greatest advocates for our profession... it will be the hospital and health plan administrators, who won't want to pay for a Cadillac solution to a Ford problem. Link to comment Share on other sites More sharing options...
SocialMedicine Posted May 10, 2013 Share Posted May 10, 2013 i believe many places just bill under the physician name if insurance companies reimburse only 85%. And I am sure if you work in a setting you know which plans do what and you quickly find ways around the system. Link to comment Share on other sites More sharing options...
SocialMedicine Posted May 10, 2013 Share Posted May 10, 2013 i believe many places just bill under the physician name if insurance companies reimburse only 85%. And I am sure if you work in a setting you know which plans do what and you quickly find ways around the system. Link to comment Share on other sites More sharing options...
physasst Posted May 10, 2013 Share Posted May 10, 2013 i believe many places just bill under the physician name if insurance companies reimburse only 85%. And I am sure if you work in a setting you know which plans do what and you quickly find ways around the system. And many places are going to be finding themselves audited for that in the future as well.....LOL. Incident to billing has very specific requirements that have to be met. As PAs increase their visibility and profile in various practices, this auditing will become MUCH more commonplace. Link to comment Share on other sites More sharing options...
physasst Posted May 10, 2013 Share Posted May 10, 2013 i believe many places just bill under the physician name if insurance companies reimburse only 85%. And I am sure if you work in a setting you know which plans do what and you quickly find ways around the system. And many places are going to be finding themselves audited for that in the future as well.....LOL. Incident to billing has very specific requirements that have to be met. As PAs increase their visibility and profile in various practices, this auditing will become MUCH more commonplace. Link to comment Share on other sites More sharing options...
Hemegroup Posted May 10, 2013 Share Posted May 10, 2013 Congratulations! Link to comment Share on other sites More sharing options...
Hemegroup Posted May 10, 2013 Share Posted May 10, 2013 Congratulations! Link to comment Share on other sites More sharing options...
Gordon, PA-C Posted May 11, 2013 Share Posted May 11, 2013 Reimbursed at 85%, paid at 50% (or less), what's not to like about PAs? It's not the docs who will be the greatest advocates for our profession... it will be the hospital and health plan administrators, who won't want to pay for a Cadillac solution to a Ford problem. Speak for yourself. You want to market yourself as a "cheap" service then go right ahead. I'm not a Ford though, I'm a cadillac and I deserve to be paid like one. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 11, 2013 Author Administrator Share Posted May 11, 2013 Speak for yourself. You want to market yourself as a "cheap" service then go right ahead. I'm not a Ford though, I'm a cadillac and I deserve to be paid like one. You're a board-certified MD? Didn't think so. No one "deserves" to be paid anything. It's all about supply and demand, cost of labor, barriers to entry, and other things. Ego is your enemy when negotiating a salary. Further, you'll note that the money equation says nothing at all about quality of care, and if you're taking offense at an imagined insinuation, you're offended needlessly. If we're practicing gold standard medicine as PAs, it only enhances our value proposition. Link to comment Share on other sites More sharing options...
lang Posted May 11, 2013 Share Posted May 11, 2013 This is great news. Great to see positivity for the profession. Yay! Link to comment Share on other sites More sharing options...
whoRyou Posted May 11, 2013 Share Posted May 11, 2013 This is definitely good for people who are PAs now and in the future (or so I hope that is if nothing changes between now and ... ) Link to comment Share on other sites More sharing options...
Gordon, PA-C Posted May 11, 2013 Share Posted May 11, 2013 You're a board-certified MD? Didn't think so. No one "deserves" to be paid anything. It's all about supply and demand, cost of labor, barriers to entry, and other things. Ego is your enemy when negotiating a salary. Further, you'll note that the money equation says nothing at all about quality of care, and if you're taking offense at an imagined insinuation, you're offended needlessly. If we're practicing gold standard medicine as PAs, it only enhances our value proposition. I am every bit as good as a board-certified MD, and I deserve to get paid the same. Equal work for equal pay. PAs should only get paid less than doctors if they provide an inferior service. You seem eager to admit that, I AM NOT. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 11, 2013 Author Administrator Share Posted May 11, 2013 I am every bit as good as a board-certified MD, and I deserve to get paid the same. Equal work for equal pay. PAs should only get paid less than doctors if they provide an inferior service. You seem eager to admit that, I AM NOT. Yeah... good luck with that. Let me know when you don't need supervision, and can yourself supervise PAs, can write prescriptions that cross state--and sometimes international--borders without hassle, and are board-certified as a physician, and then we can talk about equal pay for equal work. Edited to add: Oh, and if you want to tackle "equal pay for equal work", then go tackle why everybody gets paid less for seeing medicaid patients than medicare patients than commercial insurance patients, even when the visit acuity and patient acuity/problem list are the same. There is no such thing as equal pay for equal work in medicine, hasn't been for decades, and good luck fixing it. Link to comment Share on other sites More sharing options...
Gordon, PA-C Posted May 11, 2013 Share Posted May 11, 2013 Yeah... good luck with that. Let me know when you don't need supervision, and can yourself supervise PAs, can write prescriptions that cross state--and sometimes international--borders without hassle, and are board-certified as a physician, and then we can talk about equal pay for equal work. Edited to add: Oh, and if you want to tackle "equal pay for equal work", then go tackle why everybody gets paid less for seeing medicaid patients than medicare patients than commercial insurance patients, even when the visit acuity and patient acuity/problem list are the same. There is no such thing as equal pay for equal work in medicine, hasn't been for decades, and good luck fixing it. 1. I DONT need supervision, and there are many PAs like me with years of experience who dont need supervision either. 2. Ummm, MDs cant write script across state lines either unless they have more than 1 state license. The same is required of PAs. 3. Oregon just passed a law requiring that insurers pay PAs and NPs the same rates as MDs. Your opinion that PAs should get paid less than physicians is on the wrong side of the future, pal Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 12, 2013 Author Administrator Share Posted May 12, 2013 1. I DONT need supervision Yes, you do. It doesn't really matter whether you think you do, or I think you do, since THE LAW SAYS THAT YOU DO. If we're not agreed that the current law requires you and me each to be supervised by licensed physicians as we practice medicine, then we're simply not talking about the same reality. 2. Ummm, MDs cant write script across state lines either [...] Never said that they could--at least not as you interpreted that. But if an MD writes a script in state A, a patient (who was seen in state A) can fill that script in state B, no questions asked. Consider when a PA has to write an emergency refill for a patient in another state--that's when I've seen my preceptors need to get an MD to re-do their prescriptions. 3. [...] Your opinion that PAs should get paid less than physicians [...] Never said that either. I dealt with reality as it exists, and you're assuming that I endorse it. Please take the chip off your shoulder and deal with the same reality that the posts you're responding to are dealing with. I'm posting good news about our expansion as insurers recognize our cost-effectiveness, and you're complaining because those posts don't demand reimbursement parity along with the job expansion. Link to comment Share on other sites More sharing options...
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