Independent practice associations: Advantages and disadvantages of an alternative form of physician practice organization

Lawrence P. Casalino; Norman Chenven

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Independent practice associations: Advantages and disadvantages of an alternative form of physician practice organization

机译：独立实践协会：医师练习组织替代形式的优缺点

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Background: Value-based purchasing (VBP) favors provider organizations large enough to accept financial risk and develop care management infrastructure. Independent Practice Associations (IPAs) are a potential alternative for physicians to becoming employed by a hospital or large medical group. But little is known about IPAs.Methods: We selected four IPAs that vary in location, structure, and strategy, and conducted interviews with their president and medical director, as well as with a hospital executive and health plan executive familiar with that IPA.Results: The IPAs studied vary in size and sophistication, but overall are performing well and are highly regarded by hospital and health plan executives. IPAs can grow rapidly without the cost of purchasing and operating physician practices and make it possible for physicians to remain independent in their own practices while providing the scale and care management infrastructure to make it possible to succeed in VBP. However, it can be difficult for IPAs to gain cooperation from hundreds to thousands of independent physicians, and the need for capital for growth and care management infrastructure is increasing as VBP becomes more prevalent and more demanding.

机译：背景：基于价值的采购（Value-based purchasing，VBP）有利于规模足够大的医疗机构接受财务风险并开发护理管理基础设施。独立实践协会（IPA）是物理学家受雇于医院或大型医疗集团的潜在替代方案。但人们对IPAs知之甚少。方法：我们选择了四家在位置、结构和策略上有所不同的IPA，并对其总裁和医疗总监以及与该IPA有亲属关系的医院管理人员和健康计划执行人员进行了采访。结果：所研究的IPA在规模和复杂程度上各不相同，但总体表现良好，受到医院和健康计划主管的高度重视。IPA可以快速增长，而无需购买和运营物理实践的成本，并使物理学家能够在自己的实践中保持独立，同时提供规模和护理管理基础设施，使其有可能在VBP中取得成功。然而，IPA很难获得数百到数千名独立物理学家的合作，而且随着VBP变得越来越普遍和要求越来越高，对增长和护理管理基础设施的资金需求也在增加。

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《Healthcare.》 |2017年第2期|共7页
作者
Lawrence P. Casalino; Norman Chenven;
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Division of Health Policy and Economics Department of Healthcare Policy and Research Weill;

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正文语种 eng
中图分类保健组织与事业（卫生事业管理）;
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5. Independent practice associations: Advantages and disadvantages of an alternative form of physician practice organization [J] . Lawrence P. Casalino, Norman Chenven Healthcare. . 2017,第1a2期

机译：独立实践协会：医师练习组织替代形式的优缺点
6. Independent practice associations and physician-hospital organizations can improve care management for smaller practices [J] . Lawrence P Casalino, CasalinoL.P., Frances M Wu, Health affairs . 2013,第8期

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7. The association between the organization of medical practice and primary care physician attitudes and practice orientations. [J] . Ubokudom SE Social science and medicine . 1998,第1期

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9. Implementation of Evidenced-Based Care Management Practices Among Independent Physician Associations Serving Elderly Medicare Advantage and Dual Eligible Program Beneficiaries [D] . Dunphy, Jennifer N. 2019

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10. Solo Practice—Advantages and Disadvantages as It Affects the Patient the Physician and Medicine [O] . Ralph C. Teall, Dwight L. Wilbur 1960

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11. Independent Practice Associations And Physician-Hospital Organizations Can Improve Care Management For Smaller Practices [O] . Lawrence P. Casalino, Frances M. Wu, Andrew M. Ryan, 2013

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12. Case Study on IPA (Independent Practice Association) Purchasing of Laboratory Services and Physician Use of Designated Laboratories [R] . Anderson, J. 1986

机译：Ipa（独立实践协会）采购实验室服务和医师使用指定实验室的案例研究

Independent practice associations: Advantages and disadvantages of an alternative form of physician practice organization

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