RESPONSES / COMMENTS (NON-CLINICAL) - PART 2
07/28/2010
RE: Supergroup vs. IPA (David N. Helfman, DPM)
From: James J DiResta, DPM, MPH, David N. Helfman, DPM
I would have to disagree with Dr. Helfman's statement that the IPA model has faded away. In Massachusetts, IPAs and PHOs are the driving entities for payment contracting. In fact, many IPAs have joined with larger groups such as Partners and Charitas and BIDPO, which are the IPA/PHO entities that represent MGH, St. Elizabeths, and Beth Israel Deaconess Medical Centers respectively and all their affiliated physicians and health providers.
With the new payment plans threatening to converting to "group payment" models that the Commonwealth of MA and federal health care reform is mandating (capitation revisited with AQC contracts, etc...), all payments will be dispersed through these larger entities. Please, many individual providers do not have enough insight into this development and could be "left out" if they don't belong to an IPA. Saying that the IPA model has faded away is not just misleading, here in MA, which is at the forefront of universal healthcare, it could be catastrophic.
James J DiResta, DPM, MPH, Newburyport, MA, James.J.DiResta.DMS04@Alum.Dartmouth.ORG
Actually, if you read my final thoughts, I said that all three of these models do work, depending on which environment in which you are practicing. However, I probably should have stated that the IPA model has changed from the early 1990's. However, from a business perspective, I would think the larger super groups would provide much more value to a physician long-term and could participate in all contracts, including hospital-based PHO/ IPA's. I also mentioned that the IPA was really developed for a solo or smaller group to join a larger organization for managed care contracting purposes. I feel that our profession as a whole has been behind the eight ball when it comes to the group practice model when compared to other specialties.
Again, each market has a different dynamic but in most states, I would still argue that the larger super group model will thrive under any market condition or change.
David N. Helfman, DPM, Atlanta, GA, DHelfman@villagepodiatrycenters.com
