Understanding the Role and Benefits of Independent Physician Associations (IPAs)

Independent Physician Associations (IPAs) are separate healthcare business entities that are organized and owned by a network of independent practices. IPAs represent and advocate for their member physicians while also providing a framework for the delivery of healthcare services across the network.

IPA arrangements allow physicians to focus on their individual practices and treat additional patients referred by other network members. While IPAs can provide many benefits to healthcare providers, patients, and insurance companies, their role is often misunderstood. Misperceptions about the purpose and function of IPAs may prevent healthcare providers or patients from receiving those benefits. Here is an overview of Independent Physician Associations to help you understand their role and benefits.

What is an Independent Physician Association?

An IPA is similar in some respects to other healthcare organizations, such as Managed Care Organizations (MCOs) and Accountable Care Organizations (ACOs). However, IPAs differ in that they allow member physicians to retain more independence. Compared to other organizations, IPAs focus more on administrative tasks and providing a support network for their members.

While not all IPAs are the same, and some have different goals, they all share some common goals. These goals include:

• Improving patient care

• Allowing members autonomy

• Lowering costs for patients and increasing provider revenue

• Offering a diverse range of services in the network

Whereas other healthcare organizations focus more on shared standards, IPAs group physician practices into a support network. The IPA then performs several key roles to help the network meet its goals.

The Role of IPAs: Services Performed for Member Physicians

One of the main reasons IPAs form is to attract other businesses, such as working with insurance companies. Since discounted rates within an IPA are pre-negotiated, medical claims are typically lower. Insurance companies often prefer this over patients seeking out-of-network providers with varying (and often higher) rates.

In general, administrative support is one of the main roles IPAs play in the network of clinical practices. This includes direct contact between IPAs and insurance companies, Health Maintenance Organizations (HMOs), and other healthcare payers. In this way, IPAs can be seen as provider network managers. Insurance companies and other payers can then offer the IPA as a preferred network option.

IPAs often handle contract negotiations with insurance companies and other third parties. An IPA acts as a unified voice for its member physicians, functioning as both representative and advocate. This extends beyond negotiating reimbursement rates to being a voice for member providers on regulatory and healthcare policy issues.

Within the network, IPAs often implement quality improvement and care coordination initiatives. They might establish best practices for care and other clinical guidelines. IPAs often provide access to modern healthcare information technology (HIT), such as electronic medical record (EMR) systems. For members with their own HIT systems, the IPA might help integrate with other members in the network to ease patient referrals and data sharing.

What IPAs Don't Do: Common Misunderstandings

A common misunderstanding is that IPAs employ physicians and other healthcare providers within their networks. In reality, IPAs are typically just an association of independent providers who have joined together voluntarily. Similarly, IPAs are sometimes mistaken for insurance companies instead of negotiators that establish agreements between physicians and payers.

Patients may have concerns that IPAs affect their ability to choose a healthcare provider. However, patients are generally not required to choose a physician within the network. IPAs work to provide patients and insurance companies with a preferred network option with potential cost savings. But ultimately, this does not impact a patient's choice of provider.

There may also be some patient confusion between IPAs and ACOs. While ACOs do physician collaboration similar to IPAs, they serve different functions. ACOs typically focus on value-based care and shared savings models, while IPAs are more concerned with negotiating with payers. IPAs are more loosely structured than ACOs.

The Benefits of IPAs: Physician Support and Improved Patient Outcomes

Physicians who join an IPA enjoy a wealth of benefits. Membership in an IPA can lead to an individual physician seeing more patients, resulting in increased income. Healthcare companies prefer to work with larger groups of physicians that are capable of providing comprehensive services. In this way, IPA membership offers the potential for more business and a more substantial presence in the healthcare industry.

Relieving administrative burdens frees physicians to focus more on patient care. Independent physicians and smaller clinics often lack the human resources found in hospitals and other larger healthcare organizations. IPAs help fill those gaps by establishing clinical guidelines, care protocols, and standards for best practice. Documenting and administering these systems are often out of the reach of smaller clinics.

In some cases, IPAs allow member physicians to share financial risk. This could take the form of risk-sharing agreements with payers, where physicians share in the gains or losses based on the quality and effectiveness of patient care.

IPAs can even offer their members services such as payroll, bookkeeping, legal support, benefits management, and marketing services. Beyond negotiating with insurance companies, IPAs may handle claims processing and reporting services. Access to electronic healthcare records systems helps modernize smaller practices and automate data collection.

Some IPAs provide continuing medical education (CME) opportunities for member healthcare providers. This could take the form of training sessions or simply keeping members updated on advancements in medical technology and industry best practices. A larger IPA might even host annual conferences so that network members can meet and network. Even the smallest of IPAs strive to ensure all of their member practices are up-to-date with the latest standards of practice and healthcare technology.

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Contact us here or by calling us at 888.TEMP.DEV to get the help you need to support your Independent Physician Association.