Association for Public Policy Analysis & Management

Team-based approaches to delivering health care promise to reduce costs while maintaining a high quality of care. Yet little is known about the public’s understanding or acceptance of team-based care models, particularly in non-routine and primary care settings.  We use data from a new survey of U.S. citizens’ attitudes to assess the degree of public acceptance of team-based care in which nurse practitioners (NP) serve as gatekeepers. We find a large majority of the public is skeptical of the NP gatekeeping, even when appropriate systems for escalation are available. However, there is no public consensus about what policy changes should be made to free up resources to so that patients may have ungated access to physicians. These findings suggest that efforts to expand team-based care may fall short unless health policy makers better educate the public about the value of team-based care.