Frequently Asked Questions
What is the National Institute of Medical Assistant Advancement (NIMAA)?
NIMAA is a private, nonprofit 501(c)(3) organization that provides a national program to train medical assistants capable of working as effective members of a medical team in Federally Qualified Health Centers (FQHCs) and other high-performing primary care organizations.
NIMAA has national healthcare leaders as instructors, the latest on-line teaching tools, and offers concurrent experiential learning in carefully selected host clinics around the country. Finally, it prepares students to successfully pass a national certification examination. Graduates are positioned to command jobs that provide a living wage and gain access to advancement in the healthcare field.
Who is involved in NIMAA?
NIMAA is led by Community Health Center, Inc. of Connecticut and Salud Family Health Centers of Colorado, both recognized by the National Committee on Quality Assurance as Level 3 Patient-Centered Medical Homes, using teams to provide comprehensive medical, dental, and behavioral health services. Leading practitioners of primary health care are advisors and a growing group of clinics are joining as Host Clinics.
Why is NIMAA needed?
Existing training programs for medical assistants have not kept up with the transformation in health care, and do not focus on primary healthcare. Most programs focus on training MAs for traditional administrative roles (e.g., billing, scheduling) and clinical support tasks (e.g., measuring vital signs, rooming patients, assisting with procedures) in hospitals or private medical offices. Today’s leading primary care organizations are using integrated teams to deliver holistic, patient-centered care, with an elevated role for MAs. Medical assistants need collaborative and critical thinking skills and training in population management, patient panel management, and patient education to perform as effective members of these teams.
Are there other issues with existing MA training programs?
MA training can be stand-alone certificate programs lasting six to eight months or a major in a two-year associate’s degree program. The tuition for both kinds of programs often exceeds $20,000, loading high levels of debt on students for modest wage jobs.
What is the tuition for the NIMAA training program?
The total cost for the class beginning September 2017 will be $6,000 plus about $660 for books, the certification exam, and other expenses for each MA for the seven-month course. There may be a possibility of scholarships or tuition assistance at some host clinics.
What is the demand for medical assistants?
The Bureau of Labor Statistics projects a 23 percent growth in demand for medical assistants from now through 2024, much faster than the average for all occupations.
A strong national MA training program in primary care is a prerequisite for the successful transformation of the nation’s healthcare system, so we believe the demand for the particular kind of training NIMAA uniquely offers will grow. Additionally, there is need for a program that gives medical assistants access to a competitive living wage. The average annual salary for an uncertified MA is $26,500 plus benefits, while certification delivers an average annual wage of $34,000 plus benefits.
What does the NIMAA curriculum involve?
The curriculum includes an entire set of skills and courses for the medical assistant of the future. The curriculum has a heavy emphasis on communication skills, including agenda setting, goal setting and self-management support. It covers all traditional subjects, including rooming patients, vital signs, and teach-back at the end of the visit. Then we add NIMAA’s unique focus on integrated team-based primary care, covering areas such as: working in an interprofessional team; understanding the different team roles and activities; understanding how the MA contributes to care coordination; learning approaches to health coaching and self-management support for patients, including motivational interviewing; understanding a population health perspective; and working with the team to address the needs of a large panel of primary care patients. Our curriculum provides instruction on-line, in the clinic setting with the guidance of a preceptor, and during synchronous videoconference sessions with instructors.
What certificate or credential will graduates receive? What exams will the students take?
There is a NIMAA certificate with significant economic value in and of itself because of the reputation in primary care of the founders and leaders of this program. Currently, NIMAA students sit for the NHA medical assistant exam after graduation and receive the CCMA credential.
When will NIMAA be accredited?
Accreditation rules require our school to enroll and graduate students for two continuous years before we can apply for ABHES accreditation. We will submit our application in the summer of 2018 to the Accrediting Bureau of Health Education Schools. NIMAA has designed its program, curriculum, and standards to comply with ABHES requirements.
What is your overall educational mission?
NIMAA is creating a new paradigm nationally that promotes academic progression for MAs combined with parallel experiential learning, along with a far less expensive financial model that allows MAs to look forward to the future and next steps in their education. We believe most MA educational programs have fallen behind the needs of the primary care provider community. NIMAA is focused on creating MAs better prepared to function in team-based primary care practices. Because the program is being developed by leading primary care clinical organizations, the education is precisely aligned to meet current front-line needs.
How is NIMAA paid for?
There are a variety of ways that training payments can be made. The traditional approach is for students to pay. That is not necessarily an attractive option because NIMAA students will not be eligible for government student loans until early 2019 (after the two-year accreditation waiting period). We find strong interest in employers using the NIMAA admissions process much like the HR hiring process, to find the best future staff. This would be combined with an employment agreement in which the host clinic pays for some or all of the tuition and the student agrees to remain employed for some number of years once he/she is hired. Or, a host clinic might use some combination of the two.
These tuition payment options can apply to both upgrading existing staff or to new candidates in the equivalent of an apprentice role.
How does NIMAA compare to other medical assistant training programs?
NIMAA offers affordable tuition, onsite learning in NIMAA host clinics and job placement assistance. The NIMAA program also offers assistance with continued advancement through credits or contact hours towards credentialing requirements. At NIMAA, our goal is to reduce the tuition debt load and provide a streamlined learning program that is embedded in the healthcare setting.
What do you teach about team-based care?
NIMAA offers an entire set of skills and courses that are focused on the integrated team-based care MA. Our learning activities include: working in an interprofessional team; understanding the different team roles and activities; understanding how the MA contributes to care coordination; learning approaches to health coaching and self-management support for patients; understanding a population health perspective and working with the team to address the needs of a primary care patient panel. Our curriculum is experienced on-line, in the clinic setting with the guidance of a preceptor or instructor, and during synchronous videoconference sessions with instructors. Other schools do not offer a similar curriculum or skill sets. We want all MAs to work at the top of their license and influence the transformation of care.
What is the working relationship between RNs and MAs, and how do you identify the critical functions of each?
There is a very clear difference between the scope of practice of a nurse and an MA. The number one difference is that RNs are licensed staff. In some states, they can function as Allied Health Professionals and can bill some care as well under Medicare. In some states, they can complete triage and can function as Complex Care Managers at the highest level. MAs can in no way replace nurses. If a clinic site does not have nurses, often this work is returned to the doctors themselves, as the MA scope of practice and training/education does not typically support many of the actions that are more safely completed with the extended education received by BSN trained nurses.
The recent Institute of Medicine report that states that nurses should practice to the full extent of their license neglected to address the other roles that have to function more successfully in order to ensure that this can happen. For nurses to truly function at the top of their license, other team members, including and especially MAs, should be high functioning to support the work of the nurse in the care team as well.
How does the NIMAA program address and help develop the team? For example, what if a strong MA student does not feel confident in implementing standing orders on his or her own? How would the program address this issue?
NIMAA students get inter-professional education to better understand the various roles in primary care. The courses and preceptor trainings teach the MAs to be empowered and how to leverage other team members to better support patients. NIMAA teaches leadership development. Much of this is focusing on team-based care principles, and then we add hands-on activities to give students an opportunity to experience the different levels of assisting a provider. NIMAA students grow to understand what providers need to be successful. NIMAA MAs get feedback and support along the way as they integrate new skills. They learn it and immediately apply it in the clinical setting, instead of waiting for the final externship as in most traditional programs.
How about training current MAs? Would it make sense to bring current CMAs through the NIMAA program?
The initial program is designed to train new medical assistants and will cover both the traditional MA skills and the interprofessional & integrated team-based care skills. However, there is a lot of demand for upskilling current MAs, particularly in team-based, patient-centered care.
We are in the process of developing a shorter and more inexpensive program for established medical assistants. These courses will include the skills for patient-centered and team-based care not found in the traditional medical assisting program, such as health coaching and panel management. In simple terms, existing MAs could take what is in essence the second half of our program: the part focused on interprofessional & integrated team-based care skills.
We currently plan to launch these programs at the beginning of next year. Please let us know if you are interested.
We will also support health centers in establishing medical assistant registered apprentice programs. In the future, we plan to work with community colleges in offering combined programs ending with an Associate’s degree, so they can receive academic credit for our courses.
Are you trying to replace the emerging role of community health workers (CHW)?
No. NIMAA does not seek to replace any role in primary care. For team-based care to practice most effectively, better trained MAs are needed. Our graduates have the knowledge to apply for the role of community health worker, and they know how to utilize this role on the team to better impact their patients. Social determinants of health are addressed throughout the program as we touch on other roles in health-care and also how MAs can be used to collect this data. We do not have a training program focused on CHWs; please tell us if you would like NIMAA to expand in this area.
NIMAA is building the future MA to be the "in-clinic" partner to the "out-of-clinic" CHW.
Does the curriculum include communications, motivational interviewing, and other topics?
The curriculum has a heavy emphasis on communication skills, including agenda setting, goal setting and self-management support. The program teaches the students all the traditional skills of the medical assistant, including rooming patients, vital signs, and teach-back at the end of the visit. In addition, the curriculum includes learning about many of the dimensions of team-based care. We do teach our learners about motivational interviewing.
Is scribing part of your curriculum?
Scribing is not currently part of our curriculum. We understand that there is some interest in our adding a module for this in the future. Please let us know if you are interested.
Are you working with high schools?
NIMAA will encourage host clinics to collaborate with area high schools to prepare students for successful entry into our program. NIMAA also seeks to establish career pathways in post high-school education and employment opportunities for students who live and want to work in the communities served by our participating health centers.
How would this work in a union environment?
Neither of our two pilot locations has a union, but we have had several conversations with clinics that are unionized. Assuming that the union contract allows for the increased responsibilities that we are teaching, we believe this should be a win-win for employees and employers. One way to proceed might be to explore an apprentice program. Please let us know if you want to pursue this.
Does this program also include venipuncture?
Yes, this is included. For sites where MAs don’t conduct this activity, students may have experiences set up with lab partners as well. Clinics will need to purchase a few items for the skills lab focused on this. Supplies can be re-used and purchased in small amounts.
Are you training medical assistants to pack wounds?
No. MAs should not pack wounds. They would locate all the needed supplies, including consent and time-out documents and assist the provider working to pack the wound. This is critical because the provider needs support to ensure that all steps are completed in conducting a procedure.