Although General Motors will pay $2 billion in fines and settlements for building vehicles with defective ignition switches that killed over 120 people, no one will go to jail. To paraphrase Jean Rostand, “Kill one man, and you are a murderer. Kill hundreds of men, and you are a manufacturer.”
-- Neal Snyder
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Options for smaller practices
Concerns about increasing economic pressures on small medical practices run by doctors like Sharon Jellinek, described in the Sept. 5th article entitled “Doctors look for new ways to cope with health care changes,” could be overcome by participation in Independent Practice Associations (IPAs), a type of Accountable Care Organization (ACO).
IPAs such as Tandigm Health offer providers the opportunity to remain independent and solvent while meeting the new standards for efficiency and accountability imposed by the Affordable Care Act. Specifically, IPAs provide an umbrella organization for independent physicians to collectively negotiate rates with insurance plans, coordinate to improve patient care, capitalize on shared technology and programs, and potentially decrease the administrative burden on individual providers.
California, where over 50 percent of the insured population is enrolled in an ACO and/or IPA, provides compelling examples of how these organizational structures can help facilitate the achievement of the often-competing goals of cost effectiveness and quality of care. Many California physicians have joined large health systems due to their stability and economies of scale, but IPAs have proved a viable alternative for “cottage industry” physicians who seek to maintain small practices while still jumping through the requisite hoops.
Though not without their challenges, including adding another layer of complexity to the already convoluted health-care system, IPAs can help physicians focus their efforts on practicing medicine rather than managing the business of health care. Dr. Jellinek and her colleagues should explore this option before joining a large hospital practice or closing their doors.
-- Annie Reed
What a waste of time to watch the Greedy Old Party debates. Snow Bright and the Eleven Dwarfs were pathetic. If we elect any of these clowns to office it will certainly mean the U.S. is heading downhill. The lady Republican was the only one who made any sense, but the GOP does not run a woman for president unless they are also clowns. Sarah Palin is a prime example.
-- Alfred J. Graham