AMA Supports Team-Based Health Care Payment Models

The American Medical Association (AMA)’s House of Delegates passed new recommendations for creating payment mechanisms to support team-based healthcare delivery models. 

Also passed was a report that more specifically defines team-based roles and concepts including “physician-led,” “supervision” and “collaboration.”

RELATED: Healthcare Policy Resource Center

Team-based healthcare delivery models utilize integrated, coordinated, physician-led teams of healthcare professionals to provide comprehensive patient care. 

One pilot program associated with Blue Cross Blue Shield of Michigan reported a $155 million savings in 2012, and a total of $310 million saved since 2008. 

The AMA has been working to provide guidance on implementation and recommendations for the development of payment mechanisms to promote team-based model sustainability in various settings.

The report highlights the following:

  • Physicians who lead team-based care in their practices receive payments for health care services provided by the team and to establish payment disbursement mechanisms that foster physician-led team-based care
  • Physicians make decisions about payment disbursement in consideration of team member contributions, including factors such as volume and intensity of the care provided, the profession, training and experience of each team member and the quality of care provided
  • Payment systems for the physicians-led team-based care: to reflect the value provided by the team, with the savings accrued by this value shared by the team; to reflect the time, effort, intellectual capital provided by individual team members; to be adequate to attract team members with the appropriate skills and training to maximize the success of the team; and, to be sufficient to sustain the team over the time frame that is needed

Payment models are continuing to shift from volume-based structures to value-based structures, which are used for team-based delivery models such as episode-based bundle payments, global bundled payment systems, pay-for-performance programs, care management models, shared savings arrangements, combinations of incentives coupled with base salaries, and others.

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