The pros and cons of joining an independent Physician Association (IPA)

What is an IPA?

An independent physician association (IPA) is a business entity owned and organized by a network of independent physician practices for the purpose of reducing overhead costs or pursuing business ventures such as contracts with employers, accountable care organizations (ACO) or managed care organizations (MCOs).

IPAs contract with independent physicians and will then provide the services of the physicians to managed care organizations on a negotiated per capita rate, flat retainer fee, or negotiated fee-for-service basis. An HMO or other managed care plan may contract with an IPA which in turn contracts with independent physicians to treat their members at a discounted fees or on a capitation basis. IPAs can also contract with hospital systems and Accountable Care Organizations.

Benefits of joining an IPA

Optimally functioning IPAs can offer many potential benefits, including:

  • Appropriate alignment of physicians’ financial incentives
  • Efficiencies in practice administration and management
  • Political influence within the medical and broader provider community
  • Peer support
  • Optimized facilities
  • Increased ability to negotiate favorable contracts with other entities such as MCOs, ACOs, radiology, laboratory, and hospital systems
  • Independence and local financial and care management control in managed care
  • Improved services including, extended hours, urgent care, outreach services for prevention, telephone triage, and follow-up expertise

Risks of joining an IPA

Physicians considering the development of, or participation in, an IPA should be aware of the potential risks which include:

  • Underfunded capitation revenue, with risk of significant losses and/or bankruptcy
  • The trend of payers to decrease their payments to the IPA
  • Conflicts of interest for the physician between financial gain and optimal care for the patient
  • Restrictions on collective bargaining by physicians from the Federal Trade Commission and Department of Justice
  • Significant separation between primary care physicians and contracted limited specialists

Roy Steiner
October 1, 2018

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Tech-savvy tips for running an independent practice

In the 21st century, independent physicians must run a tech-savvy practice to keep up with their tech-savvy patients. Today’s proliferation of technology does not just affect the younger population. Many Boomers and even older patients are using their electronic devices more frequently for more tasks. The ability to access and communicate with their healthcare provider is almost taken for granted among those patients who use technology on a regular basis.

The independent physician can run a tech-savvy practice by:

Encouraging patients to use technology for tracking their lifestyle choices. Apps that monitor activities such as sleep and physical exercise can help the patient and the independent physician understand areas that need to be improved for better health outcomes. There are a number of apps that allow connectivity between the patient and the healthcare provider, transmitting data that can be helpful in diagnoses and healthcare strategies for that patient.

Providing electronic communication tools for patients. When a question arises outside of typical office hours, patients want to be able to communicate with their healthcare provider in the most convenient way and that usually means electronic communication. Even during office hours, many patients prefer to send a secure message rather than make a phone call.

Offering telemedicine services. A study published by the American Hospital Association in 2015 revealed that 74 percent of U.S. consumers would use telehealth services. The numbers have increased in the years since, with more patients becoming comfortable with – and some actually preferring – telehealth.

Using electronic health records (EHRs) to track, manage, and coordinate the patient’s healthcare. EHRs offer independent physicians the ability to record visit notes, collaborate with other healthcare providers, and send and receive critical information about the patient in real time. An EHR solution embodies a technology platform that adds value to the interactions between physicians and their patients, allowing for trust, a more productive and effective environment, and improving the quality of care that patients are receiving.

Roy Steiner
October 1, 2018

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What is Clinical Decision Support (CDS)?

Clinical decision support systems are designed to improve health and healthcare delivery by enhancing health-related decisions and actions.

CDS does this by providing clinicians, staff, or patients with clinical knowledge and patient-specific information, which is intelligently filtered or presented at correct times. This helps them to make an informed decision quickly and to take action. A simple example would be a drug warning for a patient; if a doctor inputs a medication order for their patient a window would come up stating that the patient has a possible allergy to that type of drug.

CDS incorporates a variety of tools to help more effective decision-making in the clinical workflow. These tools include computerized alerts or reminders to care providers and patients; clinical guidelines; condition-specific order sets; patient data reports and summaries; documentation templates; diagnostic support, and contextually relevant reference information, plus many other tools.

Clinical Decision Support Systems are not intended to replace a clinician’s judgment, but rather to provide tools to assist care team members in making timely, informed, and higher quality decisions.

Why Use Clinical Decision Support Systems?

CDS has a number of important benefits, including:

  • Increased quality of care and improved health outcomes
  • Avoidance of errors and conflicting events
  • Improved efficiency in health care delivery
  • Reduce the risk of medication errors and misdiagnosis
  • Improved cost-benefit, patient safety, and provider and patient satisfaction

Nick Dealtry
September 24, 2018

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How can independent physicians leverage search engine optimization (SEO)?

What exactly is search engine optimization (SEO) and why would an independent physician be concerned about it? Although physicians are focused on treating and ensuring the health of their patients, their practice is a business and that business must be promoted to entice new patients and, subsequently, to grow and be successful. SEO is, quite simply, a tool that enables new patients to find the practice when they search online.

Independent physicians typically have a web page for their practice. New patients who have just moved to the area or who want to find a new physician will typically first use a search engine such as Google to investigate their options. They may put in keywords for their search, such as “family practice,” “online appointments,” or “electronic health records.” If the physician’s website contains enough of those keywords for the search engine to find them, the practice will appear toward the top of the results for that new patient.

SEO seems simple but in many ways it is not. Search engines use algorithms to determine which sites rank in what position in their results. Keywords are one factor. Overloading the site with keywords will backfire, however. They should be used strategically and naturally in the description of the practice, the staff, and the provider. Refreshing content regularly will also improve search results.

Links are another factor in SEO. Internal links from blog posts back to the original site are helpful. External links to and from other sites also work well for SEO. The independent physician might have a business or community organization provide a link to the practice from their website.

SEO can also be key in social media posts, although the algorithms for social media platforms can change fairly often. Essentially, though, employing keywords relevant to the practice will rank the posts higher in a potential patient’s feed.

When considering SEO, the independent physician should think about the keywords that a potential patient might use to find the practice when searching online. Using those keywords appropriately, refreshing content regularly, and including links to and from other sites will boost the SEO and boost the number of new patients who find the practice in their search results.

Nick Dealtry
August 14, 2018

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5 reasons why there has never been a better time to switch your EHR

An electronic health record (EHR) solution for your independent practice should be designed to help you provide higher quality care for your patients and to optimize your practice management. There has never been a better time to switch your EHR because:

  1. EHRs have improved and evolved. Just as computer technology has improved drastically over the past decade, so have EHRs. More features that are more easily accessible now enable the independent physician to review complete patient data with the click of a button.
  2. You have more options than before. As the population ages, more patients will experience chronic and complex conditions. This means that collaboration with other providers will become essential. Coordinated care is made much more seamless with new EHR options that are now available.
  3. Value-based care demands an EHR. The transition to value-based care means that independent physicians must have the tools necessary to care for patients appropriately and to report on that care electronically. For example, certified EHR technology is a requirement for Advanced Alternative Payment Models (APMs) in order for the physician to qualify for added incentives.
  4. It could save your practice money and make your practice more efficient. Time spent on searching through paperwork or waiting on faxed information from other providers can make a practice inefficient and can be potentially dangerous for the patient who needs immediate and suitable care. An EHR designed for the independent physician’s needs can optimize practice management and ensure patients are treated in an appropriate and timely manner.
  5. Switching is not as difficult as you think. In fact, Elation migration is easy. Your time is valuable. That’s why we’ve designed our Clinical EHR to take less than an hour to learn. Receive one-on-one implementation support from our dedicated team. We take the time to understand your practice workflows and customize your Clinical EHR to suit your specific needs. There’s no need to reduce your patient volume or shut your practice doors while adopting Elation — we make it easy to switch.

Nick Dealtry
August 3, 2018

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10 marketing ideas for your independent practice

When you set up your independent practice, you have a lot of business tasks to handle beyond the basics of caring for patients. One of those tasks has to be developing marketing ideas for your practice. Just like any other business, your practice needs the right amount and the right kind of exposure so new patients will find you. You will also want to maintain a positive image in your community and marketing can help you reach others with that message as well.

Marketing your independent practice does not require expensive advertising. Rather, follow these ten tips to promote your business and generate a professional image in your community and beyond:

  1. Create and maintain a polished website. Use real photos of your staff and office. Include information about your practice as well as about yourself and your staff, so new patients can get to know you.
  2. Create social media accounts and maintain them consistently. Post questions, trivia, or contests to generate responses. Reply promptly to any comments or questions posted on social media. Remember to maintain privacy and security around any specific patient information, however.
  3. Build a brand, including a logo and consistent colors. Use your brand consistently on the walls in your office, on your website, on social media, and even on business cards and letterheads. You’ll want your brand to become recognizable as a professional independent practice.
  4. Monitor and maintain review sites. Yes, patients review medical practices online. Sites like Yelp are consistently checked for reviews. Again, respond to both positive and negative reviews promptly and professionally and keep responses within HIPAA regulations.
  5. Reach out to local companies to let them know about the services your practice offers, emphasizing your convenience for their employees.
  6. Offer to speak to community organizations on health topics that are your specific area of expertise. These speaking opportunities should not be sales pitches but should be informative and educational.
  7. Alert the media if you or a member of your practice wins an award, successfully completes training or a certification program, or achieves any significant accomplishment.
  8. Send regular e-newsletters to your current patients, with informative and educational articles. Include a call-to-action for them to share the newsletter and refer new patients to your practice.
  9. Promote the fact that you use the latest technology in your practice, including electronic health records that enable you to efficiently care for and communicate with your patients.
  10. Market consistently. Marketing is not a one-and-done event, but rather an ongoing process to promote your services and to promote the positive image of the practice.

Roy Steiner
July 30, 2018

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The importance of reliable and responsive customer support for independent physicians

Just as patients expect a positive experience when they visit their independent physicians, those physicians also expect reliable and responsive support from their EHRs. Running an efficient practice is crucial to being able to provide quality care in a healthcare setting. Time spent chasing down suppliers or getting answers from vendors, particularly when implementing new technology or resolving issues with equipment, can take away from the valuable time spent with each patient.

Independent physicians who want to streamline their practice through the use of an appropriate electronic health record (EHR) solution expect prompt customer support from their provider as well. From the initial installation or transfer to a new system through to questions and even urgent requests, independent physicians depend on responses that will enable them to continue seamlessly providing quality care to their patients.

Elation Health provides just that level of reliable and responsive customer support.  With our extraordinary 24/7 support, your urgent requests always get a response in 30 minutes or less. Our goal is to make Elation so easy to use, you won’t even need to contact us; however, when something does go wrong, we are here to help. We go above and beyond to support your practice, so you can stay focused on your patients.

If your practice is switching to Elation’s EHR, we will be there for you throughout the entire process. We can import all the data from your old EHR, no matter the brand, with exceptional results. Unlike most vendors, we can integrate full patient charts, including old notes, into your new Elation experience. We have experience with many vendors and can work with whatever system you may have.

Customer support is crucial for independent physicians, both as you provide support for your patients and as you expect support from your providers. Elation is about building – and supporting – a technology platform that doctors and patients use because they want to use it. Because they trust it. Because it improves the quality of care. Because it makes them more productive and more effective. And most of all, because it deeply respects that the heart of healthcare is the doctor-patient relationship.

Nick Dealtry
July 24, 2018

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Driven by value-based care, independent small and solo practices are on the rise

After several years of decline in the number of independent practices in the US, a recent study has shown a recent increase. The study, conducted by Black Book Research, found that “independent and physician-led group practices began to rally back up to 72.0% in 2017.” Previously, the trend had been toward independent physicians moving to hospital employment or employment in a practice with only some ownership.

Doug Brown, Founder of Black Book Research, states that the recent trend is probably a result of population health and value-based care models “driving more coordinated, integrated and consumer-centric physician organizations.” Brown adds that “Physicians not affiliated with hospitals are recognizing there are long-term savings if they assume risk and manage population health in the same way as a hospital in an ACO.”

To that end, however, many independent physicians are hiring consultants to help them determine the requirements and benefits of joining an Accountable Care Organization (ACO). When asked about the move to value-based care and how it would affect their practice, many stated they have “no strategic plan activated for transforming population health management or value-based care solutions end-to-end to confront known deadlines because there are no internal experts identified.”

Very few of those physicians surveyed have begun value-based care software vendor selection activities. Of the 900 physician organizations that participated in the survey, “95% of group practice and large clinic Chief Information Officers state they do not have the information technology or staff in-house needed to transform value-based care end-to-end as their physician and or executive team envisions.”

Overall, the research indicates that while more physicians are choosing to remain or to become independent because of value-based care initiatives, they continue to need expert help in understanding how to benefit from the population health and value-based models.

Roy Steiner
June 29, 2018

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Independent physicians seek EHR systems that meet their unique needs

Independent physicians know what they want – and they want more – from their electronic health record (EHR) systems, but many are underutilizing their EHR’s current features. These are the findings of a recent study conducted by Black Book Research that included larger practices with a dozen physicians and more, as well as smaller and solo practices.

According to the study, “93 percent of practices use the three basic EHR functionalities most often: data repository, order entry and results review.” Among those larger practices, with 12 or more physicians, 30 percent expect to replace their current system within the next three years.

The Black Book study found that a significant majority of independent physicians “are looking for cloud-based and mobile tools that offer on-demand data and visibility into financial performance, compliance tracking and quality goals” as well as “speech recognition capabilities and support for telehealth and virtual care.”

Even though independent physicians indicated in the poll that they want more out of their EHR, most of the smaller and solo practices are “still under-utilizing advanced features such as electronic messaging, clinical decision support and patient engagement tools.” In addition, those providers still see interoperability as a “sticking point.”

Independent physicians may need to ramp up their use of advanced technology, including cloud-based EHRs, as younger patients see those aspects of a medical practice as a growing need. A similar study of consumers, also conducted by Black Book, found that “a commanding 91 percent of patients younger than 50 said they prefer tech-savvy practices with advanced capabilities and connectivity.”

Smaller, independent practices will have to make that investment in EHR capabilities that will benefit their patients as well as their practice to continue to be successful. Elation Health is focused on helping those independent physicians by building a powerful technology-driven ecosystem that will become the home base of every patient’s health, and eventually transform the delivery of healthcare itself.

Nick Dealtry
May 29, 2018

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What is a web-based EHR?

The choice of an electronic health record (EHR) solution can make a significant difference to an independent physician’s practice. The EHR is designed to ensure the physician has access to patients’ medical information, can collaborate with other physicians, and has the communication tools necessary to follow up with patients after the visit. The choice also involves deciding whether the independent practice will use a web-based EHR.

The web-based EHR is cloud-based, meaning it does not use an internal server. With cloud-based EHR systems, data is stored on external servers and can be accessed with any device that has an internet connection, while server-based EHR systems store data within the practice on a personal server.

Cloud-based EHR systems actually solve many of the issues that independent physicians may be concerned about when choosing to adopt an EHR system. In server-based EHR systems, thousands of dollars are often spent to install and implement a server, hardware, and software. Additionally, regular maintenance and management from a local IT department is also needed. In contrast, web-based EHR systems are already established by a software as a service (SAAS) provider, meaning the expense of money and time diminishes dramatically.

As a recent article in the AJMC points out, “With cloud-based systems, physicians don’t have to worry about system meltdowns, natural disasters or weather patterns that can literally crash systems in a horrifying blink of the eye. Backup requirements, protocols and capabilities with traditional EHR/EMR systems are not always as secure nor provide safeguards. Patient data stored on the cloud will always be there, accessible from anywhere and at any time.”

Security concerns, particularly about patient confidentiality, are addressed by the cloud-based server’s careful and tactical efforts (such as conducting risk analyses, encrypting data, etc.) in order to assure that a patient’s medical data is kept safe and private. The 1996 Health Insurance Portability and Accountability Act (HIPAA) helped to insure and protect the confidentiality and security of healthcare information. Included in this “healthcare information” are patients’ electronic protected health information (ePHI). Consequently, this type of data must be heavily safeguarded.

The convenience of a web-based system manifests itself in the independent physician’s ability to access patient data from virtually anywhere. Cloud-based EHRs offer a range of advantages for independent physicians who would rather focus on patient care instead of having to worry about hardware and software issues.

Roy Steiner
May 22, 2018

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