Looking to 2011

The holiday season is here and 2011 is near. We have seen a lot of change. Obama care with its orders to “pass the bill so you can read it”, on-going threats of Medicare reimbursement cuts, a rapidly consolidating hospital marketplace and accelerating physician practice acquisitions. Against this backdrop of healthcare evolution, your IPA is also morphing. Our calling and mission is to provide (1) improved income, (2) less hassle and (3) no more time demands for our colleague practitioners. PDA will not settle for commodity status as a simple credentialing and messenger-model contracting IPA.
Our operating strategy for 2011 recognizes that the Accountable Care Organization (ACO) concept is a structure for Federal involvement with Medicare delivery, potential direct contracting with large employers and ultimately other types of reimbursement-driven care. We believe the “pay-for-performance” concept and lump sum reimbursement reflected by the BCBS/THR contract accord is related to the “integration/aggregation” movement. To some, it is conceptually attractive to visualize the global concept of healthcare systems and their owned or contracted practitioners being deployed as efficient networks to economically deliver care. That structure could be reminiscent of physician hospital organizations (PHOs) of the 1980’s and 1990’s, i.e., the highly successful JVE with Presbyterian Healthcare System. Or, it could be like a bureaucratic HMO with a new name. The issue is in the areas of governance, (Who is the boss?); funding, (He who has the gold makes the rules); and reimbursement division among the system providers, (Three dollars for me, and one for you).
For independent physicians, whether independent by choice or because they do not get invited to play, the role of the IPA has never been more important. PDA has reorganized and is initiating discussions with healthcare systems and major physician groups. The PDA board and new physician leaders are supportive of education, enlistment and operation of a re-invigorated physician organization. Credentialing, managed care messenger contracts and day-to-day problem solving remain as important services. In addition, the IPA must add new value and determine how to best represent you. In 2011, you are entering a new business setting.
Happy and safe holidays from Buddy Miers….Blogging on a Monday A.M.as 2010 closes out

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