Medical Society of Virginia

MSV officer leads IPA creation

January 2012

Libby webWhat is an independent practice association (IPA)? An IPA is a network of independent physician practices that come together in a legal structure so that they may benefit from collaboration on clinical, operational and contracting issues.

For Russell Libby, M.D., FAAP, president-elect of the Medical Society of Virginia (MSV), it was obvious that the changing paradigms in health care were forcing physicians to reassess how they will succeed into the future. He joined his pediatric practice with another pediatric practice, two internal medicine practices and an eleven-office family practice group to form a primary care IPA, Health Connect IPA. The unifying vision for their endeavor is to develop a systematic approach inherent in the patient centered medical home (PCMH) that strives to provide high quality, cost efficient care and patient satisfaction. 

“There are different types of IPAs with operational principles that might be more appropriate for other physician specialties and/or endeavors,” Dr. Libby said. “Regardless of the legal challenges and implementation barriers to many parts of the Affordable Care Act, it has precipitated an irreversible trend toward value, cost effectiveness and quality in the delivery of health care.”

Dr. Libby explained that there are a multitude of challenges in dealing with health information technology, an aging population with chronic diseases, discerning the best evidence based approaches to care, coordination of care, and, most significantly, the shifting of payment paradigms to population based concepts like accountable care organizations (ACO). He believes that physicians need to take on this challenge and continue to provide the leadership and innovation that has been the hallmark of medicine.

“There are many opportunities to improve on the cost, quality and approach to caring for our patients and now is the time to step up and not be swept under a bureaucratic rug,” he said. “I believe it is important for organized medicine to help physicians understand how to adapt to these changes and keep their professional identity.”

An IPA can offer much more than just group contracting. When physicians participate in IPAs, they can learn best practices from each other, from both the clinical and the practice operational perspective. There are opportunities for economies of scale for purchasing supplies, insurance, health information technology (HIT) and consultative services. Physicians can be more effective at partnering and leading endeavors with health insurers, hospital and health systems, businesses and their communities when they have the organizational cohesion of an IPA. With ever increasing overhead and complicated regulatory impositions, physicians face many challenges when it comes to running a practice and understanding the business side of medicine. IPAs address this need by looking into what physicians can do to improve sustainability and moving into the future with an organized and well-evolved effort to improve care coordination and quality measures.

“There are a number of different legal structures for IPAs and degrees of clinical and/or operational integration,” said Dr. Libby. “Health Connect IPA is a not for profit entity that is currently developed around clinical integration. If the clinical integration works, financial integration naturally follows, especially as more payer contracts are coordinated through the IPA.”
Health Connect IPA was created about a year ago and has focused on creating a uniform vision and a business plan. Some of the endeavors underway include:

  • Identifying and interpreting data to give insights on patterns and costs of care for their patients
  • Defining best practices, care protocols, and ambulatory centers of excellence
  • Coordinating HIT between member physician groups
  • Implementing and demonstrating quality improvement programs that support better care and qualify for NCQA recognition
  • Working with payers and hospital systems to contract and partner

“We are creating standards and processes for ourselves and, as we evolve, expect to incorporate other physician groups in our region,” Dr. Libby said. “We believe this effort is essential to the sustainability of physician practice and a responsible, responsive and proactive response to the needs of our community and the future of health care delivery.”

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