INDEPENDENT PRACTICE ASSOCIATION PHYSICIAN GROUPS IN CALIFORNIA

We surveyed independent practice association (IPA) physician groups in California about their approaches to staffing, physician payment, and governance. Most IPAs desired more primary care physicians but not mo re specialists. Capitation was the major mode of remuneration for prim ary care physicians in 77 percent of IPAs, and for specialists in 30 p ercent of IPAs. Most IPAs also used financial incentives related to us e of referral or ancillary services. Boards of directors were dominate d by physicians, but governance tended to be centralized rather than h ighly democratic. We found that IPAs mirror many of the broader trends in physician staffing and physician payment that exist in managed car e organizations.