Healthcare Financial Operations Manual for Independent Practice Associations

Only recently, the physician setting up his own practice was considered an anachronism. And doctors loosely affiliated with an independent practice association (IPA) fared no better. Lacking capital, financial management, and the mechanisms for adequate medical and information system management, many IPAs around the country were coping with financial instability. From the outset, IPAs seemed doomed to obsolescence by the organizational efficiencies and superior resources of third-party payors. Yet, in the early 1990s, IPAs underwent a remarkable turnaround'building infrastructure, investing in MIS systems, and accepting risk'transforming themselves into genuine competitors in healthcare quality and efficiency with HMOs. In fact, IPAs have become an increasingly common healthcare delivery model, offering distinct advantages over other payors to physicians interested in the administrative gains and security of a group practice, while still retaining their autonomy. Healthcare Financial Operations Manual for Independent Practice Associations is the first comprehensive guide to setting up an IPA, detailing the many operational, legal, and logistical complexities of managing a physician-owned organization. Since controlling the financial and tax aspects of an IPA is critical to its survival, the Manual addresses an entire range of financial accounting concerns, including accounting concepts and methods for an IPA, internal control procedures, insurance issues, tax issues, policy guidance, and profit-making issues. Specific topics addressed include: How to manage and report primary, specialty, and inpatient care How to credential IPA providers How to negotiate contracts for single specialty and multispecialty IPAs Antitrust laws and IPAs'with a case study of a Florida IPA Why IPAs fail The book also clearly outlines how to acquire and negotiate a managed care contract and, with the help of its disk, provides a host of checklists, forms, and five sample contracts (not included in the book) that allow the user to chart his or her progress and get quickly up to speed on the essential paperwork. The Manual also provides hands-on advice on setting up an efficient computer system for an IPA, reflecting the acknowledged role of a first-rate information system in an IPA's success. Offering candid, real-world guidance on setting up and successfully administering an IPA, Healthcare Financial Operations Manual for Independent Practice Associations is the complete reference to making an IPA work'for both doctor and patient. JAMES W. KARLING, CPA, is founder and President of Karling & Associates, an eighteen-person CPA firm located in San Ramon, California, which specializes in providing consulting and accounting services to the healthcare and managed care industry. Prior to founding Karling & Associates in 1994, Jim was a partner for eighteen years with Ernst & Young and has also been National Director of Arthur Young & Company's healthcare practice. He has been a frequent speaker at healthcare programs and seminars and has published a number of articles on healthcare financial issues. REED TINSLEY, CPA, is director of Horne CPA Group's Physician Services Division. His entire practice is centered in the healthcare industry and he works closely with physicians, medical systems, and other delivery systems with managed care contracting issues. A leading speaker on a variety of healthcare topics, his seminars have been sponsored by the American Medical Association. He is cochair of the CPA section of the IPA Association of America and the author of Performing an Operational and Strategic Assessment of a Medical Practice and Valuation of a Medical Practice, also from Wiley. JOE D. HAVENS, CPA, is shareholder in charge of the Horne CPA Group's Hattiesburg, Mississippi, office and a member of its board of directors. He heads a team of healthcare consultants to physicians, medical groups, IPAs,