Independent practice associations must be prepared to change or die, says healthcare governance guru James Orlikoff, setting a challenging tone for the national meeting of The IPA Association of America, held late last month in San Diego.
The key transformation for IPAs should be a shift from tactical response to the marketplace to strategic planning, says Orlikoff, president of Orlikoff & Associates, a Chicago-based healthcare consulting firm.
Simply serving as managed care contract negotiators is no longer enough.
Healthcare is moving from a wholesale market, with costs paid by insurers and health plans, to a retail market in which patients pay more out of their pockets, Orlikoff says.
IPAs should capture that high-margin, low-volume retail business by offering the FDA-approved services patients want but which are not yet approved for reimbursement, he says.
And IPA leaders must be willing to practice "tough love" by pushing their physician members to embrace new business models.
"The IPA leader's job is to force doctors to do what is consistent with strategy," Orlikoff says. It may be painful, but it is necessary, and it will never happen if the leader waits for a consensus among members.
With meeting registration down to 325 attendees this year, TIPAAA president and CEO Albert Holloway says his organization will provide more services and fine-tune its educational offerings for TIPAAA constituents.
"If this industry is going to survive--and that's a tremendously big if--we have to add value to our respective physician members," says Holloway.
"Everything a doctor needs in his practice he should be able to get from his IPA."
Holloway says TIPAAA will encourage IPAs to get their members actively involved in using information technology, and to inspire them to become more active in shaping public policy.
"Physicians don't always want to sit at the table in process design, but they have to if they want to be in a position to influence," he says.
"New, stealthy competitors are emerging under the radar screen, availing themselves of disruptive technologies," Orlikoff points out.
"What is happening in your IPA markets is not happening to you, it is happening because of you. If you change the way you behave, what is happening to you will change."