IPA represents the association of independent practitioners and providers who want to keep themselves away from the politics and the hustle and bustle of the extensive healthcare facilities. They are more inclined to provide tailored care to the patients in need with the best medical practices to provide quality care. But there can be some Independent Practice Association pros and cons that can affect the services rendered.
But to get the idea of how IPA works, look at the information provided in the article today.
Independent Practice Association – IPA
Independent practice associations are also referred to as independent practitioner associations. It is a group of medical practitioners that contracts with Accountable Care Organizations (ACOs), Health Maintenance Organizations (HMOs), and Management Care Organizations (MCOs).
Practitioners in the medical industry who want to be at the forefront of providing quality service and primary medical care to patients are more attracted to IPA. Why? Because IPA let these practitioner groups contribute to risk contracts despite their independent lack of administrative resources.
These contracts can involve collaboration with practices of different specialties, primary medical physicians, or both under a defined local area or can be in different geographical regions. Along with providing the practitioners with the facility to collaborate, they organize Clinical Integrated Network (CIN) for patient care improvement and reduce the cost of medical services in order to adopt market-competitive value-based services.
How Independent Practice association works?
Health Maintenance Organizations and other contracting associations make agreements with IPAs to contract with the healthcare providers to keep the healthcare fee at discounted rates or at a uniform fee for the IPA members.
IPA functions in its traditional form where they include all the medical practitioners and specialists. However, this doesn’t make IPA catering services of every type, but having multiple services to cater under a group of practitioners and medical healthcare providers with a uniform fee.
Since IPAs work independently and do not involve large healthcare organizations, members have complete authority over their individual practices. They can attend to patients in-house and outside at an affiliated center like Health Maintenance Organization.
However, when it comes to reimbursements, IPAs cannot negotiate for the codes and compensation on behalf of healthcare providers for the services rendered under the Federal Trade Commission Act. In this act, the federal government has established a perception which is followed to improve reimbursements. IPA is only allowed to negotiate on a capitation basis for the services contracted.
Independent Practice Association Pros And Cons
Benefits of IPA:
When IPAs function efficiently, members are subjected to receive the following benefits.
- A comprehensive ability to negotiate efficiently and effectively with health insurance companies and payer organizations in order to lessen the annual premiums for every healthcare practitioner.
- Help practitioners to expand and grow in service scale such as urgent care, prevention outreach programs, triage by phone, and following up in expertise.
- An effective integrated approach that aids in managing discrepancies and preventing medical record errors and breaches.
- Enhanced administrative, technological, and management facilities
- The capability to slide into responsible roles for care organizations (ACOs) when required.
Disadvantages of IPA:
Along with many benefits that IPA provides to medical healthcare providers, there are potential drawbacks of IPA that are worth noticing;
- Being an IPA member, a healthcare provider will not be eliminated from the duties of administration of a medical practice.
- Due to a quick growth in IPA, lack of management experience and not integrating technology in systems, IPA does not work efficiently in all its domains.
- IPAs can easily encounter antitrust concerns as they represent healthcare providers competing with the market.
Important guidelines for practitioners considering joining IPA
Medical practitioners who wish to consider joining IPA should look at these important guidelines and principles to make an informed decision before contracting IPA;
- IPA must be following a healthcare system which delivers outcomes on the basis of efficient and improved healthcare services.
- To improve the relationship between specialists, physicians, and healthcare facilities, the provision of healthcare services must be optimal which eventually helps promote the success of IPA as well as increases physician satisfaction.
- The relationship between patient and physician should be maintained uniquely.
- Healthcare providers must deliver effective and value-based services to patients which must be converted into financial benefits for healthcare providers.
- To maximize IPA benefits, practitioners should be accountable and their network should remain autonomous.
Because IPAs have drawbacks too, so it is not a panacea for a healthcare system that should be applied when improving and managing costs and patient care is the concern. Practitioners having to deal with patients under IPA contracts should learn the principles of IPA before they follow the approach.