Payment Models for Team-Based Health Care

With the increasing demand for cost-effective but high-quality health care, team-based care delivery models are emerging as a preferred method. The American Medical Association recently announced new recommendations for payment models that will sustain the team-based model of care.

According to AMA President Ardis D. Hoven, MD, the organization believes the new approach is the future of health care delivery.

"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," Hoven said in a statement.

The physician-led team-based care model can provide comprehensive patient care while reducing costs. A physician-led medical home associated with Blue Cross Blue Shield of Michigan recently reported that is saved $155 million in 2012.

The AMA was looking to recommend payment mechanisms that promote satisfaction and support the team-based model.

According to the recommendations, physicians leading the team-based care receive payments for services provided by the team and establish payment disbursement mechanisms. When making decisions about payment disbursement, physicians should consider team member contributions, such as volume and intensity of care provided, training and experience of team members and the quality of care provided.

Payment models replacing fee-for-service that focus on value include episode-based bundled payments, global bundled payment systems, pay-for-performance programs, care management models, shared savings arrangement and combinations of incentives coupled with base salaries.

"Virginia recently adopted a law that supports and promotes physician-led health care teams as a collaborative, consultative approach to health care," Hoven said. "With an aging population and a surge of newly-insured patients entering the system, we encourage other states to consider adopting this innovative approach to helping facilitate the work of highly-functioning teams of medical professionals who can meet the growing demand for health care."