The Affordable Care Act (ACA) of 2010 addressed critical healthcare workforce needs through initiatives like the Expansion of Physician Assistant Training (EPAT) grant. This program was specifically designed to increase the number of physician assistants (PAs) specializing in primary care. However, detailed analyses of the career paths of graduates from EPAT-funded programs have been lacking. This study aimed to evaluate the real-world impact of this federal investment in PA education by examining the practice patterns of EPAT program graduates.
To assess the effectiveness of the Affordable Care Act expansion of physician assistant training, researchers conducted a comprehensive survey in 2018. This anonymous electronic survey was distributed to all 27 EPAT PA programs that received funding between 2010 and 2015. The survey gathered data on program characteristics, graduate demographics, practice patterns, and graduates’ interest in future opportunities related to the program’s goals. The study received an exemption from the Institutional Review Board (IRB).
The study achieved a strong 59.30% response rate, representing 366 graduates. This sample size accounted for a significant 62.46% of the total 586 students reported by the Health Resources and Services Administration (HRSA) as EPAT-funded. The demographic breakdown of respondents highlighted the program’s success in reaching diverse populations. Notably, 16.41% of EPAT recipients identified as non-White, 4.54% as Hispanic, 53.65% as disadvantaged, and 32.92% as coming from rural backgrounds.
A key finding of the study was the strong inclination of EPAT graduates towards primary care. Sixty-three percent of graduates entered primary care practice immediately after completing their training. This number increased to 87.88% when considering those who practiced primary care at any point after graduation or at their last known point of contact. Furthermore, over half (52%) of EPAT graduates were practicing in medically underserved areas (MUAs), demonstrating the program’s impact on addressing healthcare disparities.
The research concluded that the Affordable Care Act expansion of physician assistant training, through HRSA EPAT funding, significantly boosted the number of PAs entering primary care. Graduates from EPAT-funded programs were 2.5 times more likely to practice in primary care immediately after graduation compared to the national PA average. This commitment to primary care proved to be long-lasting, persisting for several years post-graduation. The EPAT program effectively supported the training of over 140 PAs who directly began practicing in MUAs, contributing to a more diverse healthcare workforce and increasing access to care in underserved communities.
