The American Medical Association threw its weight behind emerging models of payment for team-based care—that is, as long as those teams are led by physicians.
AMA President Dr. Ardis Hoven said in a news release that physician-led team-based care “represents the future of healthcare delivery in America,” and she pointed to successful examples at high-profile health systems such as Intermountain Healthcare and Geisinger Health System.
According to recommendations adopted Monday during the AMA House of Delegates' interim meeting in National Harbor, Md., physician leaders should be the ones who receive payment for services and they should also make decisions about how much each of the other team members gets paid. Those disbursement decisions should be based on a number of factors, including volume and intensity of services, quality of care, and team members' professions, they said.
The AMA has pushed back hard against efforts to expand the scope of practice of other clinicians—most notably nurse practitioners—who have sought a larger role in providing unsupervised patient care.
In 2010, after the release of an Institute of Medicine report on the future of nursing, Dr. Rebecca Patchin, an AMA board member, released a statement arguing that physicians' level of experience and training “are vital to optimal patient care, especially in the event of a complication or medical emergency, and patients agree”
The AMA has continued to voice concerns about nurse-led practices, particularly as lawmakers in states such as California consider bills that would allow nurse practitioners to practice independently, with fewer restrictions.
Nurse practitioners, meanwhile, have fired back, arguing that their skills are sufficiently needed to address a primary-care shortage, especially in medically underserved communities. This month the American Association of Nurse Practitioners released survey results showing wide public support for easing supervision requirements for nurse practitioners.
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