Inside Report: IPAs – PHOs Definitely Worth Another Look

Independent practice associations (IPAs) and physician hospital organizations (PHOs) have risen to a prime position in the healthcare provider market, especially in recent months.

Imagine physician organizations were written off for dead just a few years ago. Impatient for successful results, hospitals and physicians were shutting down their PHO partnerships.

The smaller IPAs just faded away – just another healthcare ‘gimmick.’ A failed idea.

So the overall numbers of physician organizations has shrunk in terms of numbers of organizations, according to our research results for the National Directory of Physician Organizations Database, produced by the Managed Care Information Center.

But the PHOs and IPAs with sharp leadership stuck with it. And, today they are stronger and importantly positioned to be significant players in today’s changing provider arena.

First the major IPAs across the country proved that they were indeed viable. Led by sharp executives and leadership, patients and health plans and their members came.

“If you build it they will come.”

After a few battles with the federal trade commission physician organizations got the FTC’s green light for clinical integration initiatives.

The exploding wave of pay-for-performance programs reinforced that IPA and PHO member physicians could ramp up their quality of care measures and patient satisfaction numbers.

Because of the success of IPAs, there has also been a wave of consolidation further strengthening their position in the marketplace.

Health and managed care executives have told us about what’s shaping today’s market.

“Health Reform…it is changing the entire playing field; Significant changes in the relationships between payors, providers and patients due to health reform; tiered networks that exclude academic medical centers; Continuing movement from government and payors to P4P programs (heavy emphasis on quality); and, P4P will be easier for large carriers to implement than any real payment reform,” were among just a few of the observations shared by participants in the Managed Care Leadership Survey.

Now, even as rules governing accountable care organizations have just been proposed by the Centers for Medicare and Medicaid Services (CMS) physician organizations in several sections of the country have been out-of-the-gate first.

Physician organizations now have as physician members a major number of the practicing primary care and specialist physicians in the country.

And, as they continue to bulk up, physician organizations are having to upgrade their infrastructure, IT systems, and processes.

A rising tide does indeed float all boats; at least the IPA and PHO crafts.

Bob Jenkins

Bob Jenkins is the CEO of the Managed Care Information Center.

Research source: The National Directory of Physician Organizations Database

http://www.healthresourcesonline.com/payer-provider-data/the-national-directory-of-physician-organizations-database-on-cd-rom.html

Copyright 2011, The Managed Care Information Center, 1913 Atlantic Avenue, Ste 200, Manasquan, NJ 08736  (800) 516-4343