PA Funding Models Explained: Making the PA role sustainable long term
Physician assistants (PAs) have been recognized as essential contributors to the healthcare system. Their versatile skill set and ability to provide high-quality care in various medical settings make them a valuable resource for practices, hospitals, and clinics across the province.
To ensure the long-term sustainability of the PA role, it is crucial to establish funding models that support their salaries and create an environment conducive to their growth and professional development.
This article focuses on funding models for PAs in Ontario.
In this post we’ll explore different approaches that can help make the PA role financially viable in the long run.
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Note: Please note that while this blog post provides general guidance, it is crucial to consult with legal and financial professionals who specialize in healthcare finance to ensure compliance with local regulations and guidelines specific to your region.
As the demand for healthcare services continues to rise, it has become crucial to explore innovative approaches to meet the needs of patients effectively.
Physician assistants have emerged as an invaluable asset to healthcare teams, providing high-quality care and improving patient outcomes.
However, one of the challenges faced by employers interested in hiring PAs is finding sustainable funding models to support PA salaries and compensation packages (e.g. benefits, CME funding and education days, etc.).
I. What is a Funding Model?
A funding model refers to the framework or approach used to financially support a specific initiative, program, or role within an organization.
In the context of employing physician assistants (PAs), a funding model determines how the salary and associated costs of PAs are covered. It outlines the sources of funding, the distribution of financial resources, and the mechanisms through which the funds are allocated.
The choice of a funding model depends on various factors, including the financial resources of the organization, the goals and objectives of employing PAs, and the level of financial risk tolerance. It is common to utilize various funding models to fund a single PA position.
The ultimate aim of a funding model is to ensure the sustainability and financial viability of the PA role in the long term.
II. Importance of Funding Models for PAs
Once you have explored the benefits of hiring a PA, and identified the need for a PA through a Needs Assessment of your practice, it is pertinent to determine a business model to allow you to financially support PAs.
Here are some key reasons why funding models are crucial for the sustainability of the PA role:
Financial Considerations: Hiring a PA involves financial considerations, such as salaries, benefits, and potential training costs. Establishing a sustainable funding model helps alleviate the financial burden associated with employing a PA, making it a viable option for healthcare organizations of all sizes.
Retention and Recruitment: Sustainable funding models enable employers to offer competitive salaries and benefits to attract and retain talented PAs. This helps build a stable workforce and promotes continuity of care, leading to improved patient outcomes and higher job satisfaction for PAs.
Practice Viability: Integrating PAs into healthcare practices can enhance operational efficiency and increase patient capacity. Sustainable funding models support the expansion of services, allowing practices to meet the growing healthcare demands effectively.
Career Development: Funding models that provide opportunities for ongoing professional development and continuing education help PAs enhance their skills, stay updated with the latest medical advancements, and expand their scope of practice. This contributes to the overall professional growth and job satisfaction of PAs, leading to a sustainable and thriving workforce.
Improved Patient Care: PAs are well-positioned to address the healthcare needs of diverse patient populations. Sustainable funding models support the employment of PAs, facilitating better access to care, reduced wait times, and enhanced patient satisfaction.
III. How PA Jobs are Funded in Ontario
There is not “one way” to hire a PA in Ontario: It is common for Ontario PA employers to take advantage of multiple funding sources to support the PA’s compensation package. This results in a “patchwork” of funding sources that contributes to PA salary.
Diversification of funding sources reduces dependence on a single revenue stream. This requires careful financial planning and coordination between different funding entities. Employers must also take into consideration.
Sources of PA Funding:
Solo or Group Physician Funding: In this funding model, individual physicians or groups of physicians directly fund the PA's salary. Physicians may allocate a portion of their own income to cover the costs associated with employing a PA. In the case of group physician funding, physicians pool their billings into a collective fund, which is then used to support the PA's salary. This model allows physicians to have direct control over the funding and ensures that the PA's salary is sustained by the physicians themselves.
HealthForceOntario PA Career Start Grants: Health Force Ontario offers Career Start Grants, which are time-limited funding opportunities specifically designed for PA employers in Ontario. These grants are typically available for new Ontario PA graduates and provide financial support to assist with the employment of PAs. The grants aim to incentivize the hiring of newly graduated PAs and facilitate their entry into the workforce. Funding is available for 1-2 years, after which the employer is expected to continue funding the PA position on their own.
Hospital Foundation Funding: Hospital foundations may allocate funds specifically for PA salaries through grants or donations. Hospital foundation funding can be a valuable source of financial support for organizations looking to hire PAs, as it helps alleviate the financial burden associated with the salaries and benefits of PAs.
Research Grants: In some cases, research grants may be utilized to fund PA salaries. These grants, typically awarded by research institutions, governmental bodies, or private foundations, are intended to support research projects in various healthcare domains. If the PA's role includes involvement in research activities, organizations may seek research grants that cover not only the research project costs but also the PA's salary.
Private Industry: Private industry can also be a potential source of funding for PA salaries. In certain healthcare sectors, private companies or organizations may recognize the value of PAs in enhancing patient care and may be willing to provide financial support. This can be in the form of direct sponsorship, grants, or partnerships that help cover the costs associated with employing PAs.
Family Health Team or Community Health Centre Funding: Family Health Teams (FHTs) and Community Health Centres (CHCs) receive funding from various sources, including government budgets, to support the provision of comprehensive primary care services. These funds can be allocated towards hiring healthcare providers, including PAs. FHTs and CHCs often have a budget designated for hiring allied healthcare professionals, and PAs may fall within this category, allowing organizations to utilize existing funds for PA salaries.
It is important for employers to explore and consider multiple funding options to ensure the sustainability of employing PAs. Depending on the specific circumstances and resources of the organization, a combination of funding models or accessing multiple sources of funding may be necessary to support the PA's salary in the long term.
IV. Examples of Blended Funding Models to sustain a PA
Blending different funding sources, organizations can create a more sustainable financial model for employing PAs. This approach helps diversify funding streams and reduces dependence on a single source, increasing the stability and longevity of the PA position.
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Year 1:
50% HFO Career Start Grant Funding
50% Out of Physician Pocket (Solo Physician)
Year 2:
100% Out-of-Physician Pocket (Solo Physician): At this point, the PA may increase the roster size large enough or increase volume of patient visits per clinic that offsets the cost of PA salary
Year 3, onwards:
100% Out-of-Physician Pocket (Group of Physicians): Although initially hired by one physician, by year 3 PA is “shared” with a group physicians (in the same office) who now share the cost of sustaining the PA role.
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Year 1:
50% HFO Career Start
25% Hospital Budget
25% Department Budget (e.g. Dept. of Orthopaedics)
Year 2:
50% Hospital Budget
50% Department Budget
Year 3, onwards:
100% Department Budget
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Year 1, onwards:
100% Out-of-Physician Pocket (Solo Physicians or Group of Physicians)
In this example, the Ontario PA position was NOT funded by Career Start Grant and has been 100% out-of-pocket for physicians. Many employers do this successfully!
How is this sustainable? The PA may be seeing enough patients per day to offset the cost of overhead of the PA role. In addition the non-monetary benefits (see VI. Non-Monetary Benefits of Hiring a PA below) that enhance patient care, improve practice flow and efficiency that justify the PA position.
V. Non-Monetary Benefits of Hiring a PA
While the financial aspect is important when considering the hiring of a physician assistant (PA), there are also several non-monetary benefits associated with employing PAs:
Expanded Access to Care: PAs help address the growing demand for healthcare services by increasing access to care. Their ability to perform a wide range of medical tasks, under physician supervision, allows for more efficient use of healthcare resources and reduces wait times for patients.
Enhanced Continuity of Care: PAs can provide continuity of care by seeing patients regularly, managing chronic conditions, and ensuring consistent follow-up. This continuity improves patient outcomes, as PAs develop long-term relationships with patients and gain a comprehensive understanding of their healthcare needs.
Improved Workflow and Efficiency: PAs play a vital role in optimizing workflow within healthcare teams. They can handle routine tasks, such as taking patient histories, conducting physical examinations, and providing patient education, which frees up physicians' time to focus on more complex cases. This collaboration enhances overall efficiency and productivity.
Team-Based Approach: PAs are trained to work collaboratively with physicians, nurses, and other healthcare professionals. Their inclusion in the healthcare team promotes a team-based approach to patient care, fostering better communication, coordination, and interdisciplinary collaboration.
Patient Satisfaction: Studies have shown that patients are generally highly satisfied with the care provided by PAs. PAs often spend more time with patients, actively listen to their concerns, and provide thorough explanations, leading to increased patient satisfaction and engagement in their own healthcare.
Versatility and Adaptability: PAs are trained in a broad range of medical disciplines, enabling them to work in various specialties and practice settings. Their versatility allows healthcare organizations to deploy PAs where they are most needed, addressing specific gaps in care and increasing overall flexibility.
Professional Support: Hiring a PA can provide additional support to physicians and other healthcare professionals, reducing their workload and burnout rates.
Career Development Opportunities: For healthcare professionals, including physicians, employing a PA can offer opportunities for mentorship and teaching. PAs can assist in training and teaching other healthcare team members, medical learners (PA students, medical students, residents, fellows) contributing to the professional growth and development of the entire team.
VI. Additional Resources and References
When considering funding models for employing a physician assistant (PA), it is essential to have access to reliable resources and support.
Fortunately, in Ontario, there are various organizations and initiatives that can assist employers in navigating the funding landscape and ensuring the long-term sustainability of the PA role.
Here are some valuable resources to explore:
Canadian Association of Physician Assistants (CAPA) PA Employer Resources:
Take advantage of different resources from CAPA including the CMA PA Toolkit.
HealthForce Ontario PA Career Start Grant:
Financial and Legal Professionals: These professionals can provide insights on funding models, assist with financial planning, and ensure compliance with regulatory requirements. They can help you assess the financial feasibility of different funding options and provide guidance on navigating the complexities of employing PAs.
Peer Networking - speaking with other physicians, organizations or departments that have experience hiring PAs: Connect with colleagues and organizations that have successfully implemented funding models for PAs. Join discussions and forums where employers share their experiences and insights. Learning from others' experiences can provide valuable lessons and help you make informed decisions about funding models.
Final notes
It's important for employers to carefully assess their specific needs, explore available funding options, and create a customized blended funding model that aligns with their resources, goals, and the unique requirements of the PA role.
Engaging with financial professionals, reach out to peers who have worked with a PA before, and leveraging the expertise of funding organizations can provide valuable insights and guidance in developing a sustainable blended funding model.
