Practice Barriers in State Laws are Associated with Lower PA Salaries

Higher PA Compensation Associated with States Passing One or Both of Two Key Elements

February 20, 2020

By AAPA Research Department

Using data collected from the 2019 AAPA Salary Survey reflecting compensation in 2018, AAPA Research examined the relationship between each of AAPA’s Six Key Elements of a Modern PA Practice Act and PA compensation. This year, as with our wage parity analysis, we further tweaked our statistical model to account for even more factors that may explain differences in compensation.

[Find more information in the 2019 AAPA Salary Report]

The Six Key Elements (and number of states that have adopted them) include: ”licensure” as the regulatory term (50 + DC), full prescriptive authority (43 + DC), scope of practice determined at the practice level (37 + DC), adaptable collaboration requirements (30 + DC), cosignature requirements determined at the practice level (32 + DC), and number of PAs a physician may collaborate with determined at the practice level (14). Find more information on the Six Key Elements.

After controlling for a variety of factors that might be expected to affect compensation, we found a statistically significant difference in PA compensation related to the adoption of two of the Six Key Elements. The factors controlled for included years of experience, hours worked in a week and patients seen per week, number of weeks worked in the year, primary specialty, work setting, whether a bonus was received, whether a PA took call in the previous year, whether a PA was in a leadership role or owned part of their practice, statewide cost of living, education, race, and gender.

The analysis found that PAs are paid higher salaries when state law permits PAs to practice without a physician on site and when state law does not require a physician cosignature. While the effect size is small, the difference cannot be accounted for by over a dozen compensation-relevant factors.

Mean Base Compensation From Primary Employer by Key Element After Controlling for Various Factors*
*Note: Our analysis included PAs compensated by base salary, hourly wage (annualized by multiplying wage by hours worked weekly by weeks worked), or productivity pay. This analysis did not include bonus as the wage parity analysis did.  The analysis controlled for factors including years of experience, hours worked in a week and patients seen per week, number of weeks worked in the year, primary specialty, work setting, whether a bonus was received, whether a PA took call, whether a PA was in a leadership role or owned part of their practice, state-wide cost of living, education, and race and gender. The figure displays statistically significant differences between states that did or did not adopt a key element.

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Author of this article is Tim McCall, PhD, associate director, surveys and analysis at AAPA. Contact him at [email protected]