Question

Several physicians have formed a partnership and created an IPA. Although the initial partners are familiar with the financial implications of this medical entity, they have hired you as a consultant to explain to the entire medical group the different payer sources and risks involved with each of the payer streams. As well, they have asked you to explain to the providers in the group the relationship between the IPA and the contracting HMOs with whom they will do business and the risks involved.

Answer 1

Payers have had to know the payment models for the best results and to avoid financial risk associated with payment models..quality metrics measures risk- based financial model,provider deliver services, outcomes..To improve quality,payers has to work with right measures..private payers or Medicare shared savings program experienced with fee- for-service.. there is some difficulty for claims - based quality metrics..Health insurance companies runs with accountable care organization find patient engagement that reimbursement..

IPA ( independent practice association) serves independent Physician and providers services to managed care organization per capita rate, and fee-for-service basis..Human maintenance organization dramatically serve for millions of people in different organizational structure..Health care finance administration focus on expansion of managed care beneficiaries of Medicare and Medicaid..public program and federal regulations provides small share of most HMOs members..if HMOs remove from medicare risk contracting IPAs pay their physician fee-for-service basis..Medicare beneficiaries or medicare risk contracts HMO financial situation it will depend on IPAs services..