Perceptions of the affordable care act by Physician Assistants

Objective: Implementation of the affordable care act (ACA) resulted in an increased number of insured individuals and a shortage of primary care physicians. Physician Assistants (PAs) are poised to address this shortage since the PA profession is grounded in teamwork exemplified by the Accountable Care Organizations supported by the ACA. This study assesses the perception of the ACA by PAs providing healthcare services during implementation of the ACA.Methods: In this repeated cross-sectional study, alumni from a Midwest PA program were surveyed in 2014, 2016 and 2018 on knowledge and perception of the ACA. Questions addressed the ACA impact on the PA profession and on patients’ access to healthcare.Results: During the initial four years of ACA implementation, the following increases in perception were seen: 1) 32% increase in positive outlook of healthcare; 2) 37% increase in positive influence on PA practice; 3) 30% increase in positive impact of practice autonomy; 4) 64% increase in positive impact for patients; and 5) 33% increase in patient access to care. Additionally, the inability to choose a provider increased by 18%.Conclusions: Over the last four years PAs have perceived positive effects pertaining to their practice and regarding the impact on their patients despite an increase in the inability to choose a provider. Inability to choose a provider may in part be due to the rising number of narrow-network plans. The findings of greater autonomy and increased compensation for PAs are contrary to physicians who perceive the ACA to decrease their autonomy and their compensation.