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Nurses Rap Payment Models Recommended by AMA

John Commins, for HealthLeaders Media, November 20, 2013

"However the AMA's continual link of reimbursements to physician-led teams and outdated licensure approaches is not only anticompetitive, it limits patient choice and access to care. It fails to recognize not only the Institute of Medicine recommendation on team-based care, it also fails to recognize the national accreditation standards for team-based care and patients who are in medical homes that allow flexibility in team leadership."

The AMA's House of Delegates also passed a report that more specifically defines team-based roles and terms including "physician-led," "supervision," and "collaboration."

"Virginia recently adopted a law that supports and promotes physician-led healthcare teams as a collaborative, consultative approach to healthcare," 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 healthcare."

Kopanos says states' efforts to develop guidelines for physician-led team-based care have not worked well for nurse practitioners.

"In any state that has nurse practitioner practices owned and operated by nurses or nurse-managed health centers, their ability to participate in insurance and managed Medicaid is eroded when physician leadership is a requirement," she says.

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6 comments on "Nurses Rap Payment Models Recommended by AMA"


Jon Burroughs (11/24/2013 at 9:06 PM)
It is not either/or, it is and. In New Hampshire, nurse practitioners can work independently of physicians but choose to work collaboratively with them due to their interdependent skills and areas of expertise. One is not better than another; each brings different skills and perspectives that are equally valuable to the patient.

Brad Thornton (11/22/2013 at 8:23 AM)
Speaking as a long time nurse and less time Administrator I see mid-level and MD performance comparisons all day long. There is a constant and predictable difference in outcomes and costs in favor of the MD. However, this "clinical" competence does NOT make them a strong leader, nor does it make them effective in their management of staff or mid-levels. My experience says we need some degree of mid-level oversight but, of equal importance in the process, physicians must learn leadership and management skills....bt

Jeff angel (11/22/2013 at 4:22 AM)
Let me sum up a physician versus mid-level: depth and breadth of training, not to mention rigors of training that weed out the lazy and the ones who cannot think when tired, etc I see unnecessary tests and wrong treatment plans by midlevels nearly everyday. Like it or not, there is a big difference in training. Studies have shown midlevels order more tests/have higher costs. There is nothing wrong with supervision and collaboration. Its better care and nothing but jealousy to not want help!! Lets work together...with appropriate supervision by leaders who have more training.