Frequently Asked Questions
1. I am a specialist, can I join CIPA? Yes, all physician specialties can join CIPA.
2. Will there be a membership ceiling? CIPA will not limit its membership.
3. I am in the process of becoming a member of The Doctors Company and or the Ohio State Medical Association (OSMA). Can I still enroll in CIPA? Yes, you can join CIPA. Purchase the $499 annual membership subscription and CIPA will adjust the fee. To receive the discount, your OSMA or The Doctors Company renewal must be active within 90 days of CIPA enrollment effective date. CIPA will send you a rebate check for the difference.
4. I am a primary care physician already participating in another physician organization. Can I join CIPA and maintain a membership with the other physician group? Yes, you can join CIPA and leverage benefits of membership while affiliated with another physician organization.
5. Will CIPA provide membership discounts for physicians who are not a member of the Ohio State Medical Association (OSMA) or The Doctors Company? CIPA will continue to seek endorsements and or establish partnerships that benefit members. Currently, CIPA offers membership discounts to members of the OSMA or The Doctors Company.
6. Do I have to be independent to join CIPA? No, members can also be members of a health system, hospital, health center, or physician hospital organization.
7. Will CIPA’s annual fee increase each year? CIPA expects the membership fee to hold steady. However, there may be additional fees to participate in some value-based contracts. Members will be offered the opportunity to select which contracts they want to participate in.
8. What if my practice is sold to a health system or hospital when in CIPA. Will I have to leave CIPA? No, you will not have to leave CIPA. Employed physicians are welcome in CIPA.
9. I have five physicians in my practice or organization, do I need to pay an annual membership fee for each physician? If you have five or more physicians in your practice or group, please call 1.800.485.6603 for group membership discount.
10. Is the $99 annual membership fee for each physician or the fee for all physicians in the practice? Members of Ohio State Medical Association (OSMA) and The Doctors Company can take advantage of CIPA's special annual membership fee of $99 per physician.
11. Do I have to have an Electronic Medical Record (EMR) to join CIPA? No, an EMR is not a requirement to join CIPA.
Value-based Health Care Contracts
1. When will CIPA offer members participation in value-based contracts from health plans? CIPA’s plan is to expand membership in 2016 to 500 members. Once we have attained the membership threshold, we are well-positioned to negotiate contracts on behalf of members with Ohio health plans.
2. What is a value-based health care contract? Physician reimbursement is shifting from one of fee-for-service to fee-for-value. Fee-for-value or value-based payment contracts is a form of an alternative payment model and is structured according to a shared savings model. Shared savings arrangements differ, but in general they incentivize providers to reduce spending for a defined patient population by offering them a percentage of any net savings they realize. Examples of value-based care contracts include: ACO, Patient-Centered Medical Home (PCMH), pay-for-performance, and bundled payments.
3. What is value-driven health care? Value-driven health care is synonymous with value-based health care.
4. What is Patient-Centered Medical Home (PCMH)? The medical home model holds promise as a way to improve health care in America by transforming how primary care is organized and delivered. Building on the work of a large and growing community, the Agency for Healthcare Research and Quality (AHRQ) defines a medical home not simply as a place but as a model of the organization of primary care that delivers the core functions of primary health care.
5. How much financial incentive will I earn from value-based contracts through CIPA? Financial incentives will depend on the specific value-based contract the physician is participating in. In Michigan, some physicians earn an estimated $10,000 to $250,000 from value-based contracts.
6. When will CIPA's ACO be available? CIPA is currently accepting physician applications for enrollment in a MSSP ACO.
7. If I am currently in an ACO, do I have to use the CIPA ACO? No, CIPA members can participate in other ACOs.
8. Do I have to be a member of CIPA to belong to CIPA's ACO? No. CIPA ACO accepts all physicians. There is no membership criteria to belong to the ACO.
9. What is the cost to join CIPA's ACO? The cost to join CIPA's ACO is $2,500 per physician per year. The membership fee is refundable upon any shared savings earned by CIPA ACO members, or if members participate in billing/coding seminars or achieve marked quality outcomes.
10. How do I join CIPA's ACO? To enroll in the ACO, click here for application.
1. What is a practice partner? A practice partner is an expert consultant with many years of experience in practice transformation, Patient-Centered Medical Home (PCMH), technology, clinical measures performance improvement, and value-based contracts. Each practice will be assigned a dedicated practice partner who will offer guidance as it relates to health care trends and business and clinical transformation services to position the practice for success in value-based health care contracts.
2. Will my practice partner be working in my practice? Initially, practice partners will meet with you at your practice to conduct a practice assessment. Depending on the services purchased by the practice, some practice partners will be visiting your practice at least monthly to deliver services.
Federal and State Compliance
1. Will CIPA prepare me to comply with the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015? Through CIPA’s contract with Medical Advantage Group, a variety of business and clinical transformation services are offered to members that help practices to meet MACRA compliance. In addition, members can become a Patient-Centered Medical Home (PCMH) or participate in an Accountable Care Organization which assures compliance with MACRA.
2. Can I use CIPA to help us with compliance with MACRA only? CIPA offers members access to Medical Advantage Group services that help support practice compliance with MACRA. Services may include: PCMH, MACRA Readiness Assessment, billing and coding training, clinical quality measure optimization, and more. Medical Advantage Group expert consultants have proven methodologies and a track record of success positioning practices with the capabilities that support compliance with MACRA.
3. Can CIPA help me get started with the CMS Comprehensive Primary Care Plus (CPC+) initiative? Yes. CIPA offers members access to Medical Advantage Group services that help support compliance with CPC+. Some services may include: PCMH, EHR implementation, billing and coding training, clinical measures performance improvement, and more.
1. What resources will I have immediate access too? Members will have immediate access to Medical Advantage Group business and clinical transformation services, and education and training on a variety of topics. Members will contract directly with Medical Advantage Group for business and clinical transformation services.
2. Can I purchase services directly with Medical Advantage Group? Yes, members can purchase services directly through Medical Advantage Group; however, CIPA offers members the services at discount.
3. What is the cost of services offered by Medical Advantage Group? Each product and service is offered at a different price. Please contact 1.800.485.6603 for more information.
4. How do I contact Medical Advantage Group? Members can contact their Practice Partner who can connect you with a Medical Advantage Group representative.
5. Who is Medical Advantage Group? Medical Advantage Group (medicaladvantagegroup.com) is a health care consulting company that simplifies the delivery of efficient, high-quality health care for physician practices, independent physician associations, ACOs, health systems, hospitals, and payors. Established in 1996, Medical Advantage develops and manages physician organizations and provides the infrastructure support to physicians in order to be successful in pay-for-performance contracts. Medical Advantage Group is owned by The Doctors Company, the nation’s largest medical malpractice insurer with more than 78,000 members.
6. What is practice transformation? Practice transformation is a continuous process of bringing systems in a physician practice to fully support quality improvement and patient-centered care.
7. What is a 360 practice assessment? We come to your practice to understand how it works, and make recommendations on how to improve quality, processes, technology, increase revenue and lower expenses.
8. Is the group purchasing program connected to Michigan or is it just for Ohio physicians? As a valued member of CIPA, physician practices can participate for a fee in Medical Advantage Group's group purchasing program. The group purchasing program is open to all physician practices in both Michigan and Ohio.