Independent Physician Association: What Is an IPA Medical Care and How It Functions?

Not every person in the professional place wants work full of patient and staff noise that may hinder their performance and distract them from their healthcare provider. But when there are a lot of patients visiting doctors every now and then at a medical facility, it becomes hard to tackle the distraction that physicians may suffer. Keeping the issue in mind IPA was formed. What is an IPA medical, and how does it work? Keep reading to find out.

What is an IPA medical?

What is an IPA medical
source:verywellhealth.com

IPA is an abbreviation of Independent Physicians Association which is also called the Independent Practitioner Association that is formed for the practitioners and providers who want to keep themselves away from professional politics and distractions to provide extensive care to their patients by delivering the best practices of healthcare. The association is created by a group of doctors who came together to join hands with Health Maintenance Organizations (HMOs), Management Care Organizations (MCOs), and Accountable Care Organizations (ACOs).

IPA attracts practices and practitioners that are more inclined to provide quality care and remain in the need of additional resources to be on the front line in delivering value-based healthcare services. IPAs enable healthcare providers to be a part of risk contracts to secure themselves in case of a lack of administrative resources.

IPA approaches healthcare physicians from primary healthcare and collaborates with other dedicated providers from different specialties. Oftentimes IPAs approach physicians of specific areas defined through geographical locations. With a bunch of dedicated physicians, the association also works as a Clinically Integrated Network (CIN) to provide comprehensive patient care, adopt value-based healthcare practices, and reduce the overall healthcare fees.

What functions does IPA perform?

What functions does IPA perform
source:eehealth.org

Healthcare organizations like HMOs and other contractors contact IPAs for their value-based quality healthcare plans to provide practitioners with their dedicated plans at uniform discounted fees.

Since IPA has a variety of providers with a range of specialties and experience, IPA works mainly for primary care providers that involve one specialty service or provides practitioners for shelters, homeless healthcare centers, and for abuse treatment centers.

Since IPA is not backed up by big insurance corporations and is based on self-supporting entities, practitioners are allowed to run their own practices and offices.

In addition, practitioners are allowed to see some patients in their practice as well, which will be outside the Health Maintenance Organizations’ affiliation. With this, providers will receive compensation for the services according to discounted fee schedules or per-patient fee schedules. This means no matter how many times a patient visits a doctor; they’ll be paid every time for their services.

The contract between HMO and IPA determines the liability of IPA, which enables it to strongly adhere to the guidelines and the industry regulations defined by the government and making it easier for the patients to access practitioners.

Every provider has to sign an agreement with IPA regarding compliance with HMO and federal regulations. Otherwise, physicians will not be reimbursed for their services rendered to HMO patients.

According to the Federal Trade Commission Act, IPA is not allowed to make conversations with insurance companies regarding cost or plan structures in place of providers for the reimbursements. IPA can only negotiate about the services of members as a whole to the insurance payers or to the third party.

Advantages of the Independent Physicians Association

Advantages of the Independent Physicians Association
source:slma.cc

If IPAs are effectively participating in federally assigned plans and functioning in compliance of regulations, these benefits can be gathered;

  • Expanded services include extended hours, triage by phone, urgent care, continuous follow-ups, and prevention outreach programs.
  • Maximizing the utilization and implementation of administrative technologies with management facilities
  • An approach to effectively manage healthcare records to comparatively improve and prevent overall billing errors and discrepancies
  • An effective ability to negotiate with insurance companies, third-party payers, and paying organizations about reducing the annual premiums of patients with certain plans.
  • The ability to jump into a range of healthcare organizations responsible for healthcare such as ACOs when required.

Disadvantages of IPAs

Despite the advantages of IPA, there are some challenges of IPAs that providers often face.

  • It includes an increase in responsibilities for a provider as they cannot detach themselves from their own practice, yet they need to administer their duties as practitioners at their practice as well.
  • Some IPA based on providers and a range of specialties would lack behind when it comes to coping with upgraded and continuously changing technologies.
  • IPAs represent a competitive provider force; they also face antitrust concerns.

Endnote

Although the main purpose of IPAs is to provide improved care and reduce the cost of healthcare, they are not the whole panacea for the healthcare system. As long as providers and patients have pros for them, there would be cons for them as well.