An
HMO or other
managed care plan can contract with an IPA, which in turn contracts with independent care providers or
physicians to treat members at discounted fees or on a
capitation basis. The typical IPA encompasses all specialties, but an IPA can be solely for
primary care, could be single specialty, or could be a set of other care providers such as psychologists or even providers of social services such as food pantries, homeless shelters, or substance use disorder treatment facilities. IPAs are typically formed as an
LLC,
S Corp,
C Corp, or other stock entity. Their purpose is not to generate a profit for the shareholders although this can be done. The IPA assembles care providers in self-directed groups within a geographic region to invent and implement health improvement solutions, form collaborative efforts among care providers to implement these programs, and exert political influence upward within the community to effect positive change. Despite a perception that IPAs have been formed to negotiate as a group with insurance companies in an attempt to improve rates of compensation, under the
Federal Trade Commission Act, they cannot negotiate as a group with insurance companies for the providers' other insurance reimbursement. The IPA can only negotiate for the IPA members those services which are contracted on capitated members. "Messengers," specialists who are selected to represent individual practices, can be used by IPA members to review and discuss coding and compensation with health insurance companies. These professionals do not
collectively bargain and can only do so if the providers have reorganized under a single
tax ID number which is not an IPA model. == Benefits and drawbacks ==