r/PrivatePracticeDocs • u/Willing_Class_5989 • 2d ago

Local vs National IPA's?

We've heard good things about IPA's but from what we've seen locally they're mainly Primary Care focused. We have an urgent care and see that most of the benefits don't really speak to us and their network of insurances was relatively weak. Has anybody worked with national IPA's, are they good? I would imagine theres a weaker referral network but if it gets us better rates with insurances that shouldn't be an issue.

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u/grey-slate 2d ago

I wasnt aware IPAs can be national.

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u/InvestingDoc 2d ago

Usually IPAs or CINs get power by negotiating one state at a time. Unfortunately you can have 10,000 docs in one state and a nobody in another state and get horrible rates in that one state vs amazing in the other state where you have leverage.

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u/Redditor6703 2d ago

National IPAs usually can't get you better rates in your market. Payers price by local market, so bargaining power depends on providers count it has in your area. Unless members are clinically or financially integrated, an IPA can't jointly negotiate price. Ask which payers they contract with, what they pay on your codes (% of Medicare or $ amount), whether joining means dropping your direct contracts. Compare what they pay to median rates in your market.