The independent practice association in theory and practice: lessons from experience

Article Abstract:

The independent practice association (IPA) is a promising model of organizational structure in the managed care era that can protect physician interests by placing them in prominent roles to devise and manage health care systems. This type of organization has become effective in preserving physician independence in the San Francisco East Bay area in California. IPAs are small and can assist the process of health care policy change. Physician ethics take precedence over business ethics in the ideal IPA. IPAs need good financial and administrative controls, physician leadership, focused objectives, and a balanced number of specialists and primary care physicians to survive. Most have been centered around hospitals. The successful IPAs in the East Bay, however, appear to be abandoning the strong emphasis on physician autonomy. Physicians should get involved so their practices will not be governed by business administrators.

Innovations, Medicine, Practice, Physicians, Medical professions, Medical practice

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What do Hillary Rodham Clinton and Newt Gingrich have in common?

Article Abstract:

Health care reform requires a bipartisan agreement, which is a major reason the Clintons' plan lost favor. Conservatives and liberals should work on a plan that includes both government and markets. In the process, the problems with funding government entitlement programs such as Medicaid and Medicare will be solved. The approach suggested to attain universal coverage involves having middle-class employees accept a loss of the tax-free status of employer-provided health expenses, which would result in higher personal incomes, but higher taxes. Individuals would then be more selective in their health expenses and the burden on business would decrease. This, in turn, would force the market to adjust prices to meet competitive demand. People with higher incomes would be taxed more heavily, but these extra costs could be offset by a reform of capital gains taxes.

Economic aspects, Health insurance

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Health services research: now more than ever

Article Abstract:

The Agency for Health Care Policy and Research, a federal agency created in 1989, plays an important role in assuring quality care in a market-driven system. It has established guidelines that have been shown to save money and improve patient care. Health services research attempts to find working strategies for the actual practice of medicine. However, funds for this type of research have been reduced. The federal government spends $10 billion on biomedical research, which is 20 times what it spends on health services research. The decision makers of the health care system need reliable and objective scientific information that can be passed along to consumers.

Medical research

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