Which model involves physicians who practice in private offices under contract with the HMO rather than being employees?

Which model involves physicians who practice in private offices under contract with the HMO rather than being employees?

• A. Staff Model
• B. Group Model
• C. Independent Practice Association
• D. Open Panel

Answer: (C)

Physician independence within an HMO is what’s being tested. In the Independent Practice Association model, doctors keep their private offices and contract with the HMO through an intermediary organization—the IPA. The IPA handles negotiating reimbursement, credentialing, and referrals, while physicians remain independently practicing and not employed by the HMO. This contrasts with the staff model, where physicians are employees of the HMO practicing in HMO-owned facilities; the group model, where the HMO contracts with a single multispecialty group (which may employ its physicians); and open panel, where a broader set of physicians, including some in private practice, participate as panel providers under different terms. The scenario described fits the Independent Practice Association.

Physician independence within an HMO is what’s being tested. In the Independent Practice Association model, doctors keep their private offices and contract with the HMO through an intermediary organization—the IPA. The IPA handles negotiating reimbursement, credentialing, and referrals, while physicians remain independently practicing and not employed by the HMO. This contrasts with the staff model, where physicians are employees of the HMO practicing in HMO-owned facilities; the group model, where the HMO contracts with a single multispecialty group (which may employ its physicians); and open panel, where a broader set of physicians, including some in private practice, participate as panel providers under different terms. The scenario described fits the Independent Practice Association.