NPs, PAs Could Be Key to Access for Newly Insured Californians

Experts expect more clinical responsibilities will be shifted to nurse practitioners and physician assistants as California providers struggle to provide adequate access to care for a growing number of state residents who have gained health coverage under the Affordable Care Act, the San Jose Mercury News reports (Seipel, San Jose Mercury News, 5/17).

Background

As of April 15, about 1.4 million California residents had enrolled in a plan through the exchange. Meanwhile, about 1.9 million residents enrolled in Medi-Cal as of March 31 (California Healthline, 5/5).

Ensuring Access

Chris Perrone, a deputy director at the California HealthCare Foundation, said primary care physicians likely will shift more clinical duties to physician assistants and nurse practitioners in an effort to meet the growing demand for care for the millions of newly insured residents. CHCF publishes California Healthline.

In addition, Perrone said doctors could begin delivering more care via telemedicine services, such as phone calls and video conferences -- especially to patients in rural areas.

While some observers are skeptical that physicians will be able to meet the rising demand for care, state health and finance department officials said the state will be able to do so because most low-income individuals will be enrolled in HMOs and managed care plans. Such plans are required to provide sufficient access to network providers under their contracts.

However, health care advocates note that health care access also could be jeopardized by a 10% cut to Medi-Cal reimbursements, which already are among the lowest Medicaid payments in the U.S., according to the Mercury News.

Perrone said, "Unless we expand access ... or change the way we practice, we will not meet the demands" (San Jose Mercury News, 5/17).