Independent physicians look to cut costs by joining an independent physician association. There are many legal parameters to look into before joining one to steer clear of anti-trust laws.

Balancing the Private Practice

The largest complaint from private practice physicians is the lack of time they have for their patients due to the administrative stress they face. Increasing the number of physicians and staff in a practice can help balance out the work. However, despite these efforts, it can still be difficult for private practices to stay afloat. Physicians are searching for the best way to maintain their private practices despite the financial problems they’re facing. A Medical Economics article summarizes alternative options that physicians can turn to.

An increasingly popular route for many physicians is joining independent physician associations (IPAs). Physicians can operate independently, but also join forces with other providers for medical services. This alliance equips them with better leverage for negotiation purposes, such as with insurance companies. IPAs contract their own billing and professional liability companies, creating one less worry for physicians who are part of the organization.

In order to be able to provide such benefits; however, IPAs need to adhere to federal guidelines and be sure to not infringe upon anti-trust laws, since they undertake great financial risk. There may be a fixed rate for services depending on patient background. It’s also presumed that the IPA will put forth efforts to minimize costs and ensure better patient care.

Another advantage of IPAs is the resources they can provide. Individual physicians are on limited budgets, but in a group organization, they have access to IT support and better software with more integrated features, which results in better services. This enables them to improve patient care by recognizing which patients are high-risk and require greater care.

There are a few other options physicians have if they feel that IPAs aren’t for them:

  • Physician-Hospital Integration: A professional services agreement is used for hospitals to contract doctors when necessary.
  • Physician Enterprise Model: Physicians keep their practices, but are employed by a hospital.
  • Independent Practice Groups: A single company provides centralized services to those physicians who are members of the group.

Another factor physicians must deal with is cost. Rent payments and staff salary are two expenses a practice cannot get by without. It’s best to use professional advice for such matters, to ensure that it’s smoothly dealt with. The practice should also have a designated person to confirm that the services they’re providing are properly billed. According to the article, a majority of practices fail to bill for approximately 12% of the services they perform.

Though a practice’s primary concern is patient care, it’s also necessary that they get compensated for their work in order to keep the practice running. Verifying patient referrals and insurance authorizations can help prevent payment issues. It may also be helpful to ask for co-pays at check-in. These tips can be the key to maximizing revenue.

Author: Apoorva Anupindi