Southeast texas physicians INTEGRATED network

1. Southeast texas physicians INTEGRATED network An Independent Physician Association

2. INDEPENDENT PHYSICIAN ASSOCIATION Some of us physicians went into independent “solo” practice because we wanted to be our own bosses and be in control of our professional life. In today’s changing healthcare environment, how long can we maintain our independence?

3. Advantages of staying independent. Why should we stay independent?

4. Advantages of staying independent • AMA REPORTS 53% PHYSICIANS IN 2012 WERE SELF EMPLOYED • In 2012 54% of FPs and 26% of IMs sold out to big groups. • In 2013 only 31% Family Physicians and 22% of IM sold out to hospitals and other groups SOURCE: MEDICAL ECONOMICS APR 25, 2013

5. Advantages of staying independent • Total control of our practices • Reduce unnecessary waste in overhead seen in group practices

6. Advantages of staying independent • Establish personal relationship with our patients. • Freedom to schedule vacations, CMEs etc.

7. Advantages of staying independent • Young doctors able to raise their families because they can control their time. • NEW style practice like going concierge etc.

8. THREATS TO INDEPENDENCE WHAT ARE SOME OF THE THREATS TO OUR WAY OF LIFE?

9. Threats to Independence • Growing regulatory pressures • Privacy rules • The burdens of billing and collections • Steep investments to incorporate electronic health record (EHR) systems • Onerous requirements of data collection

10. Threats to Independence • Pressure from big groups trying to buy out • Pressure from hospitals to take away hospital privileges

11. Advantages of IPA What are the advantages of an IPA?

12. Advantages of IPA • Collective Bargaining • Sharing knowledge • Sharing resources • Group power

13. Advantages of IPACollective Bargaining • Ability to negotiate compensation with insurance companies. (according to Federal Trade Commission, this can only be done under one Tax ID)

14. Advantages of IPA Sharing knowledge • By sharing knowledge on billing and coding, we can increase our revenue. • E.g 2 years ago, I learned about Medicare annual well visits from a physician colleague and increased my revenue by 30%

15. Advantages of IPASharing Resources • Potentially we can form an LLC that can own Lab, Radiology etc. • Hospice Agency • Cosmetic Procedure lab (lasers etc.)

16. IPA MODEL PROPOSED IPA MODEL

17. Proposed IPA model • KISS. • Form like a club, that meets every month. • One Tax ID and organize as LLC, register with State of Texas as such. • No employees till we get comfortable with one another. • Free to negotiate with anyone you like. • Management by one of the group. On rotation.

18. Proposed IPA model • If Insurance companies, hospitals, or big groups try to approach one of us, we have power to refuse or negotiate the way we want things done. • When we get comfortable with one another, we will think about ancillaries. • Absolutely no fee to join except, costs of forming LLC, food and drinks during monthly meetings.

19. Proposed IPA model • Collective advertising on the Web and Bill boards (the cost is a lot less when shared) • Limited to physicians absolutely good quality. Those with poor quality cannot join the IPA. • IPA Totally controlled by the group, not by “practice managers”

20. SETPIN • Integrity • Independence • Intellect