Addressing Health Workforce Shortages: The Critical Role of the Physician Assistant Profession and Title VII Funding

By Tyler Smith, Senior Director of Government Relations at the Physician Assistant Education Association

Throughout the COVID-19 pandemic, the issue of health workforce shortages received unprecedented attention. As patients sought care during one of the most pressing public health challenges in our country’s history, the impact of long-standing workforce gaps, particularly in rural and underserved communities, became clear. Now, as we move beyond the acute phase of the pandemic, the Physician Assistant Education Association (PAEA) is committed to doing its part to expand access to care by supporting our members as they work to prepare the next generation of providers and increase this essential workforce.

PAEA represents the 300 accredited PA training programs nationwide, which collectively graduate more than 10,000 new PAs each year. As part of the Association’s work, PAEA’s Government Relations team advocates on behalf of federal investments, commonly known as Title VII programs, which seek to improve the supply, distribution, and diversity of the nation’s health workforce. In alignment with the Coalition for Health Funding’s support of funding for the entire spectrum of health care delivery, PAEA’s appropriations advocacy focuses on three key programs: Primary Care Training and Enhancement grants, Scholarships for Disadvantaged Students, and Area Health Education Centers.

Primary Care Training and Enhancement Grants

A key component of ensuring health for all is promoting equitable access to a high-quality primary care system equipped to treat the most common illnesses impacting patients. To address this challenge, public policy must support the development of a robust primary care workforce. One of the federal government’s long-standing investments to support this goal is Primary Care Training and Enhancement (PCTE) grants. The PCTE program funds PA student, medical student, and physician resident training in primary care through investments in curriculum development, clinical rotations, and faculty development. As of academic year 2020-21, the PCTE program facilitated educational experiences for over 1,300 PA students with 62% of clinical rotations occurring in medically underserved communities. 

The PCTE program is one of the few sources of direct federal support for PA education, and recent funding levels have proven inadequate to combat competing incentives for graduates to enter specialty care. As of fiscal year 2022, fewer than 10% of current PA programs were awarded PCTE grants—a concerning shortfall at a time when nearly 98 million Americans live in a designated primary care health professional shortage area. To improve access to care, Congress should significantly increase PCTE funding to reduce clinical training site shortages, strengthen clinical experiences in underserved communities, and build a sustained pipeline of PA graduates to primary care.

Scholarships for Disadvantaged Students

Beyond the issue of primary care provider shortages, the racial and ethnic disparities in health outcomes that persisted throughout the pandemic highlight the need for continued investments in health workforce diversity. The Scholarships for Disadvantaged Students (SDS) program provides grants to health profession-focused schools to distribute to economically and educationally disadvantaged students. In fiscal year 2020, 2,664 disadvantaged students were awarded scholarships through SDS with 65% of these students identifying as part of an underrepresented minority community.1

As is the case with PCTE, while SDS has been critical in allowing some PA students to successfully progress from matriculation to graduation, current funding levels are insufficient to significantly influence workforce diversity. Following the most recent funding competition in 2020, only 5 PA programs received an SDS award. For this reason, PAEA strongly supports continued funding increases to expand pathways to the health workforce for students that more accurately reflect the communities they will go on to serve.

Area Health Education Centers

Since its inception, the PA profession has recognized the unique value of team-based care to ensure optimal patient outcomes. That is why PAEA has consistently prioritized the Area Health Education Center (AHEC) program as a component of the Association’s advocacy efforts. The AHEC program was designed specifically to support interprofessional training opportunities in rural and underserved communities that typically have the greatest difficulty in recruiting and retaining providers. In academic year 2020-21, the AHEC program supported over 27,000 clinical training experiences for health professions trainees, including PA students, with approximately 68% of these experiences taking place in medically underserved communities.1 To build upon this progress, and in recognition of the ongoing issue of clinical rotation shortages in health professions education, PAEA urges Congress to continue to prioritize funding increases for this program.

While many lessons have been learned because of COVID-19, one of the most critical is the importance of having a sufficient supply of well-trained health providers that reflect the patients they serve in the communities where they are needed most. For this reason, PAEA is committed to continuing its vigorous advocacy on behalf of these and other sources for health funding in partnership with our CHF colleagues. We welcome the opportunity for ongoing collaboration with all CHF members in our collective pursuit of health for all.