11 min
Episode 35: Should I Join An IPA or CIN? The Private Medical Practice Academy
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- Entrepreneurship
One of the questions that I’m frequently asked is whether physicians should join a provider network? First, let’s get the alphabet soup mumbo jumbo out of the way. IPA stands for Independent Practice Association and CIN stands for Clinically Integrated Network. Today, I’m going to talk about the things that you will want to think about when considering if you should sign up for one of these networks.
As a physician participating in one of these networks, you’ll be paid according to the provider network’s master contracts. I also want to be clear that you can also see patients outside of the insurers contracted through the provider network. You don’t have to limit your practice to only patients within the network.
Independent Practice Association (IPA)
Loosely formed alliances among physiciansPrimarily focused on independent private practicing physiciansMain purpose for forming an IPA is for payer contractingWith the recent changes in reimbursement from fee-for-service to value-based, IPAs that aren’t not clinically integrated can’t effectively negotiate payer contractsClinically Integrated Network (CIN):
Consists of a group of providers who come together to improve quality and cost efficiency in healthcare deliveryProvide higher value to the consumer of healthcare servicesEmploy best practice, process improvement methodologies and measure true cost and outcome metrics via direct methods such as patient surveys and activity-based cost accounting methodsFacilitate referral optimization by matching patient needs with those providers best capable of meeting those needsContract for services on behalf of their membersUsually include a care management or care coordination infrastructure as well as an IT infrastructure that serves multiple purposesIn the end, you have to do the due diligence to make sure that you will be gaining enough—either in better contracted rates or reduced overhead—to make it worth joining a provider network.
For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcast
Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com
Join my FB group, The Private Medical Practice Academy.
Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.
Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.
Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." -- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!
One of the questions that I’m frequently asked is whether physicians should join a provider network? First, let’s get the alphabet soup mumbo jumbo out of the way. IPA stands for Independent Practice Association and CIN stands for Clinically Integrated Network. Today, I’m going to talk about the things that you will want to think about when considering if you should sign up for one of these networks.
As a physician participating in one of these networks, you’ll be paid according to the provider network’s master contracts. I also want to be clear that you can also see patients outside of the insurers contracted through the provider network. You don’t have to limit your practice to only patients within the network.
Independent Practice Association (IPA)
Loosely formed alliances among physiciansPrimarily focused on independent private practicing physiciansMain purpose for forming an IPA is for payer contractingWith the recent changes in reimbursement from fee-for-service to value-based, IPAs that aren’t not clinically integrated can’t effectively negotiate payer contractsClinically Integrated Network (CIN):
Consists of a group of providers who come together to improve quality and cost efficiency in healthcare deliveryProvide higher value to the consumer of healthcare servicesEmploy best practice, process improvement methodologies and measure true cost and outcome metrics via direct methods such as patient surveys and activity-based cost accounting methodsFacilitate referral optimization by matching patient needs with those providers best capable of meeting those needsContract for services on behalf of their membersUsually include a care management or care coordination infrastructure as well as an IT infrastructure that serves multiple purposesIn the end, you have to do the due diligence to make sure that you will be gaining enough—either in better contracted rates or reduced overhead—to make it worth joining a provider network.
For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcast
Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com
Join my FB group, The Private Medical Practice Academy.
Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.
Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.
Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." -- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!
11 min