AMA Turns Its Attention to New Payment Models | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

AMA Turns Its Attention to New Payment Models

November 19, 2013
by John DeGaspari
| Reprints
Passes recommendations that support new approaches to team-based healthcare

The American Medical Association (AMA) has adopted new recommendations for creating payment mechanisms to sustain what it describes as team-based health care delivery models that it says are emerging as the preferred method for providing coordinated, cost-effective, high-quality health care for patients.

“The success rate of physician-led team-based models of care has been proven time and again by trusted industry leaders like the Mayo Clinic, Geisinger Health System, Intermountain Healthcare and Kaiser Permanente,” said AMA President Ardis D. Hoven, M.D., in a prepared statement.

According to the AMA, physician-led, team-based models are successfully improving quality and reducing costs by leveraging integrated, coordinated, physician-led teams of health care professionals to provide comprehensive patient care through health care delivery systems. It cites as an example a physician-led medical home associated with Blue Cross Blue Shield of Michigan which recently released preliminary data showing a $155 million savings in 2012, and a total of $310 million saved since 2008.

With increasing numbers of large integrated health care systems, health insurance companies and physician practices of all sizes establishing these models, the AMA has been actively working to provide guidance on implementation, including a report outlining recommendations for the development of payment mechanisms that promote satisfaction and sustainability of team-based models in various practice settings. In the report the AMA calls for:

  • 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; and
  • 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.

To further aid implementation of these new models, the AMA also passed a report that more specifically defines team-based roles and concepts including “physician-led,”  “supervision” and “collaboration.”

 

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

Geisinger National Precision Health Hires Illumina Exec to Lead Business Development

Integrated health system Geisinger has hired a high-profile genetic counselor to head up business development for Geisinger National Precision Health, which was created to extend the Geisinger model on the national scene.

$30M VC Fund Launched to Spur Innovation in Cardiovascular Care

The American Heart Association, together with Philips and UPMC, has announced the launch of Cardeation Capital, a $30 million collaborative venture capital fund designed to spur healthcare innovation in heart disease and stroke care.

Epic Wins Labor Dispute in Closely Divided Supreme Court Decision

Epic Systems Corporation won a major labor-law ruling in the Supreme Court on Monday, centering around the extent of corporations’ right to force employees to sign arbitration agreements, and with a 5-4 ruling in its favor

Survey: Two-Thirds of Physician Practices Seeking Out Value-Based Care Consulting Firms

Most physician organizations are not prepared for the move to value-based care, and 95 percent CIOs of group practices and large clinics state they do not have the information technology or staff in-house needed to transform value-based care end-to-end, according to a recent Black Book Market Research.

Cumberland Consulting Buys LinkEHR, Provider of Epic Help Desk Services

Cumberland Consulting Group, a healthcare consulting and services firm, has acquired LinkEHR, which provides remote application support, including Epic help desk services.

Population Health Tool that Provides City-Level Data Expands to 500 Cities

A data visualization tool that helps city officials understand the health status of their population, called the City Health Dashboard, has now expanded to 500 of the largest cities in the U.S., enabling local leaders to identify and take action around the most pressing health needs in their cities and communities.