The AMA recommendations call for:
- Physicians who lead team-based care in their practices to receive payments for healthcare services provided by the team and to establish payment disbursement mechanisms that foster physician-led team-based care;
- Physicians to 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 physician-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.
Not surprisingly, nurses associations are not embracing a list of recommendations that leaves physicians calling all the shots.
"We have supported integrated models of care moving towards reimbursement alignment for quality and outcomes over fee-for-service," says Tay Kopanos, DNP, FNP, vice president of state government affairs for the American Association of Nurse Practitioners.