Healthcare is dominated by decisions. Decisions to choosing the right healthcare plan, the right primary care physicians, the right insurance carrier, and more. Each decision is important; one decision can impact your options for others. For example, which insurance carrier you choose will affect which primary care physician you can use.
Therefore, making the decision which medical group or Independent Practice Association (IPA) to use is an important part of your healthcare plan.
Let’s first take a look at how to choose the right Medical Group and Independent Practice Association is, then let’s examine what factors you should consider when deciding which medical group or IPA to choose.
Medical Group vs. IPA
An Independent Practice Association is an organization of physicians established to contract with third party payers. Not every doctor wants to sell their practice to a hospital or larger practice. An IPA allows physicians who aren’t one, combined corporate entity, to enjoy the benefits of a larger organization. They don’t have a legal relationship with one another, they remain independent practices.
A medical group is collection of doctors who have partnered with one another, contractually. The purpose of this partnership is to share the care of patients. They are considered one legal entity and can contract with third party payers.
How to Choose a Medical Group
How you choose your medical group will depend on whether or not you already have a primary care physician (PCP). If you do have a PCP that you trust, you’ll just go with the group your doctor is associated with. If you don’t have a primary care physician yet, here’s a few questions to ask yourself.
- Is the medical group a part of the health plan you’ve chosen?
- Is there a primary care physician within the group in your area?
- Do the group have specialists you might need access to?
- Which hospitals have relationships with the doctors in the medical group?
- Does the group have diagnostic services?
- Is there a proper system for referrals and coordination of other medical information between the doctors?
- Are physicians in the medical group Board Certified or Board Eligible?
- Does the medical group offer online services?
Why Choose an Independent Practice Association?
Physicians who are a part of an independent practice association have more freedom than doctors in a specific medical group. That’s because they’re independent and can do what’s best for the patient. They’re part of the group for billing purposes. When it comes to services, they are free to do what’s best for their patients.
This means you get more personal service, unique to your needs. Doctors can prescribe any medication and refer you to any other doctor. Their focus is your health, not the restrictions of an overarching medical group. Therefore, your PCP can perform or recommend any test or treatment they feel is necessary for your health care.
Your first step is to choose your healthcare plan. Then you can worry about determining which primary care physician and medical group or independent practice association you should choose. More times than not, individuals choose their doctors and let that dictate the medical group. But if you’d like to know everything about your healthcare plan, the doctor, and the medical group, discover the answers to these questions.
Image Courtesy of Phalinn Ooi