11/03/2026

HB 963 Spotlight: Eliminating the PA-to-Physician Ratio

Ohio House Bill 963 seeks to align state law with modern PA education and practice, for the benefit of Ohio patients and healthcare teams alike.

This article is part of a series focusing on the 14 actions within HB 963 that modernize PA practice in Ohio.

Action:

Eliminate the PA-to-physician ratio.

Rationale:

Removing the 5:1 PA-to-physician ratio increases staffing flexibility, especially in areas with provider shortages. This change improves access.

Every healthcare team is built around the needs of its patients. A busy emergency department, a rural clinic, and a behavioral health practice each need a different mix of clinicians.

Ohio law, however, applies one formula to all of them. A physician may not supervise more than five physician assistants at any one time, no matter the setting, the patient volume, or the experience of the team.

When there’s so much important work to be done, a fixed ratio is one more hurdle standing between Ohio’s healthcare teams and their patients.

Ohio PA Susan Hollobaugh, PA-C, MSCAM, DFAAPA, states it simply:

"The 5:1 PA-to-physician ratio limits opportunities for PA practice, and it limits MDs and DOs by restricting how many PAs they can work with, now and in the future. With a limited number of specialists and primary care providers, and decreased availability for appointments, removing the ratio would allow more opportunity for patients to receive care in a more timely manner.”

Ohio PA Nathan Hart, MS, MBA, PA-C, adds:

"In large health system with many locations, each campus is different, with its own patients, its own demand, and its own staffing needs, and no formula can account for that. When a site needs to add a PA to bring down wait times, a fixed ratio shouldn’t be what stands in the way. Patients are waiting for appointments, and we have trained clinicians ready to see them. Giving health systems the flexibility to build the right team at each location means more people get care sooner.”

Eliminating the 5:1 ratio preserves collaboration with physicians while giving practices and health systems the flexibility to build teams that fit their patients’ needs, so more Ohioans can get care when and where they need it.

Learn more about this and other aspects of House Bill 963, and how you can advocate for PA practice advancement, today.