Recently, there's been dramatic growth in the number of nurse practitioners (NPs) and physician assistants (PAs). The number of NPs has more than tripled in the last decade while the number of PAs has almost doubled.Yet, due to particular billing practices in Medicare, it can be difficult to know how care these clinicians are providing. That means there's a lot we don't know about access and quality related to this critical part of the health care workforce.Ateev Mehrotra from Harvard Medical School and Beth Israel Deaconess Medical Center joins A Health Podyssey to discuss how we bill for nurse practitioner and physician assistant services and the implications of those practices.Mehrotra and colleagues published a paper in the June 2022 issue of Health Affairs examining the prevalence of "indirect billing," where care provided by a PA or NP is billed under the supervising physician.They found about 11 million instances of Medicare indirect billing in 2010 and 30 million in 2018 and estimate that eliminating indirect billing would have saved Medicare more than $190 million.Order the June 2022 issue of Health Affairs for research on costs, care delivery, COVID-19, and more.Subscribe: RSS | Apple Podcasts | Spotify | Stitcher | Google Podcasts