Ama Policy

Financial Penalties and Clinical Decision-Making H-180.942

Risk—Physicians Taking

Our AMA opposes: (1) the practice of a payer utilizing statistical targets alone (and not outcomes data) to determine ‘cost effectiveness’ of a therapeutic choice; and (2) the practice of a payer imposing financial penalties upon patients, physicians, and/or associated physicians based upon the use of statistical targets without first considering the clinical factors unique to each patient’s claim.

Policy Timeline

Res. 213, A-19