An independent practice association (or IPA ) is the US term for independent physician associations, or other organizations dealing with independent physicians, and provides services for care organizations managed at the negotiated captains, flat retention fees, or negotiable costs-for-services.
Video Independent practice association
Operation
HMOs or other managed care plans can contract with IPA, which in turn will contract with an independent physician to treat members with discounts or with capitation. The typical IPA includes all specializations, but IPA can be solely for primary care or can be a single specialty.
IPA is usually formed as an LLC, S Corp, C Corp, or other stock entity. Their goal is not to generate profits for shareholders although this can be done. IPA assembles doctors in self-directed groups within geographical areas to create and implement health care solutions, establish collaborative efforts among physicians to implement these programs, and use upward political influence in the medical community to generate positive change.
Although there is a perception that IPA has been established to negotiate as a group with insurance companies in an effort to increase the level of compensation, under the Federal Trade Commission Act, they can not negotiate as a group with insurance companies for reimbursement of other physician insurance insurance. IPA can only negotiate for members of the IPA services contracted out to the capitalized members. "Messengers", a specialist selected to represent individual practice, may be used by IPA members to review and discuss coding and compensation with health insurance companies. These professionals do not bargain collectively and can only do so if doctors have reorganized under a single tax ID number that is not a science model.
Maps Independent practice association
Benefits and disadvantages
Benefits
Joining IPA allows doctors to focus on providing care. Many IPAs offer facility management service organizations (MSOs) including payroll, bookkeeping, benefit management, group purchasing, compliance, marketing, and online reputation management. IPA can also offer doctors an information technology platform that offers automation and/or connection to the Electronic Health Record (EHR) system. In addition, a structured IPA as a risk-taking entity may provide physicians with an interest in the ability to participate in risk contracts even if they do not have administrative staff to coordinate. Most importantly, IPA offers physicians strength in numbers, having tens to thousands of doctors represented together giving a single doctor the ability to participate in programs that will not be available.
Weakness
There are significant potential weaknesses that may be related to IPAs as well. Joining IPA will not waive doctors from all administrative duties in running medical practice. Also, some IPAs may not work effectively; this can be due to rapid growth, lack of sufficient experience management teams, or rapidly changing technology in the field. It is also possible for IPA to face antitrust issues as they may represent competing healthcare providers. [1]
References
Bibliography
- American Public Policy: An Introduction to 7th Edition
- Essentials from Managed Care, 4th Ed, Peter Kongstvedt
- De Wolf W, and A Stanten. 1995. "The Independent Practice Association". JAMA: Journal of the American Medical Association . 274, no. 22: 1761.
- Roth M. 1979. "Is the Independent Practice Association for You?" Doctor Management . 19, no. 1: 42-6.
- 2002. "LATE - PRECEDENT REGULATION - The FTC OKs a Deal That Will Allow Independent Doctor Practice Associations for Contracts with Health Plans on Behalf of Doctors". Modern Health Care . 32, no. 8: 6.
External links
http://aihinc.com/
Source of the article : Wikipedia
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