Is Alliance an IPA?
Is Alliance an ACO?
Yes. We are a network of physicians who have come together to successfully provide coordinated, high quality care to our patients.
Why should I join Alliance rather than stay with my current IPA?
Existing IPAs are, for the most part, purely administrative. Alliance offers a dynamic platform to meet the challenges of the market and provides population health services that are not currently available to independent physicians in the rural Texas areas.
Is Alliance a clinically integrated network?
Not yet, but it has already begun the development of its clinical integration program and may seek an advisory opinion from FTC at the appropriate time with respect to its clinical integration activities.
Is Alliance being built to sell to hospitals, an insurance company or any other healthcare company?
No, it is purposefully built to be a sustainable long-term community asset.
How does Alliance pay for the population health services and technology?
As part of the contracts offered by the payors to Alliance, we will receive payment from the insurance plans for the provision of population health services for physicians and their attributed patients. Alliance’s goal is to help physicians meet or exceed agreed upon quality standards and manage the population in a more cost effective way than the market.
Why should I join Alliance rather than a hospital network?
Alliance allows for you to remain independent and still enjoy the services and structure needed to be successful in the new value based world of healthcare.
Since Alliance is a nonprofit, what happens when there is a surplus?
In return for providing services to and through the Network, any surplus will be dispersed 70% to the doctors who are members and 30% to the sponsor.
Why does the sponsor member participate in the surplus?
It will be providing all the services and technology necessary to run the network. The only way for it to make money is for the doctors to make money, thus aligning incentives.
Do I still bill for my services directly to the insurance companies?
Yes, you will bill commercial insurance companies directly on a Fee for Service basis, as you do now.
What happens if I save money (create a gain share) and other providers don’t?
First, Alliance as a whole has to save money for there to be a gain a share. If there is a gain share, the finance committee made up of physicians will establish a formula that is transparent to all members to decide how to divide the savings.
Who decides what contracts Alliance signs?
The physician executive board in conjunction with the management company.