Independent Physician Associations: Rethinking Growth

Growing can be stressful. A great deal is at stake: financial gains, capacity, resources, time, and even relationships with patients.

Such a growth quandary has led physicians to band together in the delivery of care, forming independent physician associations (IPAs), as an alternative against incremental costs and declining reimbursement rates in the complex healthcare environment.

With the increasing popularity of value-based healthcare, these self-supporting organizations are currently developing and rethinking not only resilience throughout the care continuum but also competitive edge by adapting to new infrastructures and technologies with full accountability and autonomy.

What Is an Independent Physician Association?

In a nutshell, an IPA is a physician association that is organized, owned, and managed by a network of independent physician practices.

These business entities negotiate physician reimbursement with governmental and commercial payers with the aim of delivering cost-effective care.

They compete directly with other large hospitals/medical groups by providing a range of services to patients from a specific population while maintaining independence.

Part of being independent, enables these organizations to have more bargaining power and influence during negotiations.

Keeping Independent Physician Associations in the Spotlight

Retaining independence and being responsible for the adequate delivery of care can be daunting. This is why sharing expertise and resources sets the basis of this type of association.

And the common goal is pretty much straightforward: to personalize care delivery in an industry that is driving more decisively towards value.

More importantly, these organizations are also getting stronger pressure to meet the demands of the modern patient.

According to a 2020 survey of healthcare consumers, patient satisfaction is now determined by the quality of engagement that exists between providers and patients, making effective communication and listening, either in-person or virtually, a must to ensure rewarding patient experiences.

Following the same pattern, another study reported that 79 percent of physician-owned practices acknowledge the importance of investing in effective patient-provider communication and deeper engagement as a source of durable advantage.

Other taxing factors impelling physicians to form IPAs are also concerned with:

• physician burnout from handling mountains of patient-related data and reporting requirements;
• insufficient training or knowledge to manage technology at work, including EHR best practices;
• inability to meet industry-specific requirements and gain financial incentives; and
• increasing costs from government reporting and changing reimbursement models.

Enabling Independent Physician Associations to Meet Value-Based Outcomes

IPAs operate at a bigger scale by delivering comprehensive services to a larger population base, owing to their capabilities and capacity to adapt to higher risk arrangements.

By doing so, they secure better patient outcomes, profitability, and lower readmissions in light of supreme efficiency, all of which contribute to value-based services.

Paying attention to a specific population requires a series of strategic steps that encompass the following components:

Define your patient population

Before positioning your IPA in the market, it is vital to first identify your target population.

Your target population is a specific group or groups of people you plan to provide care in a systematic and consistent manner.

For instance, some IPAs focus on primary care, others pursue single specialties, or both. Yet IPAs also define their population target based on geographical parameters.

Knowing your population helps identify specific needs at a larger scale and determines which kind of providers deliver the most value to your network.

Some IPAs search for behavioral specialists or even home health agencies to improve the quality they provide to their patients.

Raise the quality bar in one great leap

As mentioned above, IPAs gain a significant bargaining power to negotiate with stakeholders, namely payers and other providers, to improve the quality of their services.

The shift from volume to value is making physicians adopt shared systems, establish common care delivery guidelines, and build the right infrastructure to ensure patients receive a level of service that matches industry expectations.

The rule of efficiency also prioritizes the use of digital tools and resources to accelerate positive outcomes, reduce overheads, and increase value.

To improve performance, group patients according to the amount of health risk they pose and the costs involved for delivering care.

This will enable your team to better focus on high-risk and high-focus patients.

Become an authority

Support your organizational branding by establishing authority in your area of expertise.

From a marketing perspective, gaining authority status enables healthcare organizations to amplify their brand message, facilitating a smoother market penetration while attracting new customers (patients).

With more patients onboard, there is a better opportunity to optimize the continuum of care, leading to better population outcomes.

An additional recommendation is to recruit the right leadership whose expertise makes all the difference in inpatient care, specialty care, and other management areas with a patient-first focus.

Ready for Growth?

When it comes to the complex healthcare environment, diligence matters. That said, your IPA needs a sophisticated platform that can help your team unleash their full business potential.

QuickCap, our best-in-class, value-based healthcare administrative solution, can help your team unleash their full business potential by enabling you to:

• customize your contracting and adapt pricing for traditional fee-for-service, value-based, and fee schedule payments;
• auto-adjudicate claims and process various record formats, such as EDI files, scanned claims, and more;
• automate processes, workflows, and authorization verifications through a rule-based system;
• validate member eligibility and meet requirements for enhanced accuracy in the provision of care; and
• simplify the management of data with electronic data interchange (EDI) files, electronic health records (EHRs), and other relevant clinical documentation.

From processing claims smartly to accessing valuable data, QuickCap has everything you need to move your IPA forward.

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