Physician-Hospital Arrangements In Professional Integration

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Professional integration and the type selected for many healthcare organizations will determine their success when they begin implementation of the Patient Protection and Affordable Care Act (PPACA). Cuellara & Gertlerb (2006) list the five most common arrangements in use: Independent Physicians Associations (IPAs), Open Physician–Hospital Organizations (OPHOs), Closed Physician–Hospital Organizations (CPHOs), Management Service Organizations (MSOs), and Fully Integrated Organizations (FIOs). Each of these five types of professional integration has proven successful however there have been many failures, which ultimately led to a degraded access and quality of health care in those communities. Major Points of Two Selected Types of Physician-Hospital Arrangements The two types of physician-hospital partnerships that I have selected are the IPA and FIO. IPAs and FIOs are arrangements at the opposite end of the professional integration spectrum. The major points for each type are described below. Independent Physicians Associations (IPAs) IPAs are a group of physicians who own a practice and are not employed by another healthcare organization such as a hospital or health maintenance organization (HMO). IPA physicians form a legal corporation, partnership, or foundation and contract as a group to provide their services. Some IPAs contract with HMOs while also seeing non-HMO patients. The IPA shares economic risk but not overhead costs. Fully Integrated Organizations (FIOs) Under the FIOs structure the healthcare enterprise purchases a physicians practice to include the physician’s services. Physicians become salaried employees and in some organizations they share governance with healthcare management. However, FIO... ... middle of paper ... ...g/publications/policy_primers/pdfs/pp-2005-12.pdf. Cuellara, A. E. & Gertlerb, P.J. (2006). Strategic integration of hospitals and physicians. Journal of Health Economics, 25(1), 1-28. Retrieved February 21, 2011, from Fraschetti, R. L. & Sugarman, M. (2009). Successful Hospital-Physician Integration: Shared governance and decision-making help a California integrated health care network thrive. Pivot Health website. Retrieved February 21, 2011, from St. Jude Heritage Medical Group Home Page. (2011). St. Jude Heritage Medical Group Awarded Top Honors. St. Jude Heritage Medical Group website. Retrieved February 23, 2011, from

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