PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Independent Practice Associations”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources
PubMed2003

Effect of tiered prescription copayments on the use of preferred brand medications.

BACKGROUND AND OBJECTIVE: Health plans are increasingly using more open drug formularies that offer differential prescription copayments as an incentive to enrollees to use brands that plans prefer. How much this financial incentive affects use of preferred brands has not been widely reported. The aim of this study was to estimate the effect of tiered copayments on the choice between preferred and nonpreferred brand medications. MATERIALS AND METHODS: Longitudinal logistic regression analyses of pharmacy claims from 1998 and 1999 comparing concurrent groups that were or were not exposed to tiered copayments. SUBJECTS: Enrollees in four independent physician practice association model health plans who had pharmacy claims for angiotensin converting enzyme inhibitors (ACEI), proton pump inhibitors (PPI), or hydroxymethylglutaryl coenzyme A reductase inhibitors (STATINS). OUTCOME MEASURE: Change in the percentage of prescription claims that were for preferred brands. MAIN RESULTS: Regression adjusted estimates of the average net increase in the percentage use of preferred brands of ACEI, PPI and STATIN from first quarter 1998 to third quarter 1999 attributed to tiered prescription copayments were 13.3 (P = 0.001), 8.9 (P = 0.03), and 6.0 (P <0.001) percentage points, respectively. CONCLUSIONS: Tiered prescription copayments were associated with a significant shift from nonpreferred to preferred brand medications. This type of financial incentive can help purchasers providing open access drug benefits by steering use of medications toward lower cost brands. The clinical effects of changes in medication use brought about differential copayments warrant further investigation.

Aged↗
PubMed1999

Antitrust defense.

Explore the source record for details and available documents.

American Medical Association↗
PubMed1997

My brother's gatekeeper.

When doctors launch their own managed care ventures, they soon find that cost control means care control. And in policing their own, they must resort to the techniques used by other health plans--gatekeepers and all.

American Medical Association↗
PubMed1996

Joining a capitated IPA: should you, or shouldn't you?

The "bygone" doctor practiced in the good old days under a relatively uncomplicated, clearly defined system. Physicians could afford to be independent. To survive in practice today, say the authors of "Renegotiating Health Care: Resolving Conflict to Build Collaboration," physicians must adapt to change or the health-care market will pass them by. Today's "evolving" doctor is a partner, contributing to and deriving benefit through collaborative patient-care networks, physician practice organizations, and medical services organizations. Historical rivalries have been forgotten as hospitals, insurers, and physicians seek and achieve innovative alliances. Still, resistance to these plans runs strong. The following story typifies one dilemma that faces physicians today. It concerns a hypothetical group practice that must decide whether to form a capitated individual practice association.

Capitation Fee↗
PubMed1994

Modeling adherence to colorectal cancer screening.

BACKGROUND: An explanatory framework referred to as the Preventive Health Model was used to identify factors associated with prospective adherence to colorectal cancer screening. METHODS: Data on sociodemographic, psychosocial, social influence, and program factors were collected via telephone survey for 501 older adult members of an independent practice association-type health maintenance organization. Subjects were later mailed fecal occult blood tests for completion and return. Adherence was defined as the return of the tests within 90 days. RESULTS: Structural analysis shows that for men (N = 145), perceived self-efficacy (OR = 1.4), salience and coherence of testing (OR = 2.3 for a 5-point increment on a 30-point scale), and exposure to health education interventions (OR = 6.8) were significant independent predictors of intention to adhere and of adherence. Among women (N = 185), predictors were age (OR = 1.8) and salience and coherence of testing (OR = 1.8 for a 5-point increment on a 30-point scale). CONCLUSIONS: These findings indicate that for both men and women, adherence is influenced strongly by the extent to which the behavior is judged to make sense in everyday life. It also appears that additional education and encouragement may persuade men and younger women to participate in screening.

Age Factors↗
PubMedDate not supplied

Pay for performance: its influence on the use of IT in physician organizations.

The introduction of information technology (IT) in physician organizations and practices is a source of great interest to physician leaders and policy makers. In this article, the authors describe what may be the nation's largest pay-for-performance program, its performance metrics, and incentives for the implementation and use of IT in medical groups and independent physician associations (IPAs). Results include the increased use of electronic clinical data, point-of-care technology, and the generation of more actionable reports for quality improvement. Noteworthy are the efforts by physician organizations to enhance data collection to demonstrate improved clinical performance and earn financial incentives.

California↗
PubMed2002

The feasibility of paper-based Tracking Codes and electronic medical record systems to monitor tobacco-use assessment and intervention in an Individual Practice Association (IPA) Model health maintenance organization (HMO).

Despite evidence of its effectiveness, tobacco cessation is not systematically addressed in routine healthcare settings. Its measurement is part of the problem. A pilot study was designed to develop and implement two different tobacco tracking systems in two independent primary care offices that participated in an IPA Model health maintenance organization in Portland, Oregon. The first clinic, which utilized a paper-based charting system, implemented CPT-like tracking codes to measure and report tobacco-cessation activities, which were eventually included in the managed-care organization's (MCO) claims database. The second clinic implemented an electronic tracking system based on its computerized electronic medical record (EMR) charting system. This paper describes the pilot study, including the processes involved in building provider acceptance for the new tracking systems in these two clinics, the barriers and successes encountered during implementation, and the resources expended by the clinics and by the MCO during the pilot. The findings from the 3-month implementation period were that documentation of tobacco-use status remained stable at 42-45% in the paper-based clinic and increased from 79% to 88% in the EMR clinic. This pilot study demonstrated that Tracking Codes are a feasible preventive-care tracking system in paper-based medical offices. However, high levels of effort and support are needed, and a critical mass of insurers and health plans would need to adopt Tracking Codes before widespread use could be expected. Results of the EMR-based tracking system are also reviewed and discussed.

Costs and Cost Analysis↗