Midlands Voices: Time to remove barriers for PAs, patients

The Omaha World-Herald published an op-ed by Kurt Schmeckpeper, PA-C, president-elect of the Nebraska Academy of PAs. See the full text of the op-ed below. 

Imagine being required to provide a service, one that you’re highly skilled at and that you have experience providing. Now, here’s the catch: You have to provide this service knowing you won’t be paid for it. No matter what your job or profession, that’s not sustainable.

Now consider this real-life scenario. A physician assistant in a rural town works in a certified rural health clinic for years and treats a high percentage of patients covered by Medicare. Most services provided by PAs are covered. However, Medicare requires that all rural health clinics offer certain diagnostic tests — not covered in the usual payment bundle made to such clinics — to all patients who need them. A health professional would have to have access to direct payment to receive reimbursement for these tests. However, PAs are the only providers who submit bills to Medicare but cannot receive direct payment for the services they provide.

This has to change. The Centers for Medicare and Medicaid Services estimate that the Medicare population will increase to 81 million by 2030 — and for PAs practicing at rural health clinics, that presents challenges.

The good news is that in April, U.S. Rep. Adrian Smith, R-Neb., joined Rep. Terri A. Sewell, D-Ala., to introduce bipartisan federal legislation to fix this inequity. H.R. 5506, the Physician Assistant Direct Payment Act, would allow PAs to receive direct payment for services covered under Medicare. If approved, this would allow PAs in Nebraska and throughout the country to continue providing high-quality care to Medicare patients — and get paid for it. This would also give PAs the flexibility they need to care for all patients in every medical setting and model of care, regardless of whether those patients are covered by Medicare.

Passing this legislation is simply the right thing to do, particularly as PAs become more and more a part of the health care delivery system across the country.

PAs are medical professionals who diagnose illness, develop and manage treatment plans, prescribe medications and serve as principal health care providers. You’ll find them in every state, every medical setting and every specialty. In Nebraska, there are more than 1,300 PAs, and about 41 percent of them practice in rural areas.

Demand for PAs is high — the profession is expected to grow 37 percent from 2016 to 2026, according to the Bureau of Labor Statistics. More and more students are choosing the PA profession, and in underserved areas with limited access to health care, that influx of PAs can help ensure that the baby-boom generation has access to critical health care services.

Ultimately, PAs are increasing access to care for patients all across Nebraska. Whether you live in a rural, urban or suburban area, PAs can and will provide you with high-quality medical care — and this legislation will help them do just that.

The writer is a physician assistant at Bryan Health-Crete Area Medical Center in Crete, Nebraska. He serves as the president-elect of the Nebraska Academy of PAs.