SAN MATEO: Orthopedic Surgeons Pull Out Of IPA Contracts
Thirty orthopedic surgeons in San Mateo County "resigned their contracts" with three independent practice associations (IPAs), protesting that the groups' fee structures are "too low and unfair." Dr. Alan Zacharia, president of the Northern California Orthopedic Medical Group, said, "The numbers we were getting paid from the IPAs, who took contracts from the HMOs, had gotten so low we could no longer afford to do our business." Patients referred to the orthopedic surgeons must now pay a standard fee or provide alternative insurance coverage. "It's not a strike. It's a matter of not accepting discounted fees for the services we were providing," said Zacharia. The three IPAs the doctors resigned from are Mills-Peninsula Medical Group, San Mateo IPA Medical Group and Bay Care Medical Group.
The resignations may be influencing the IPAs' policies, said Zacharia, because "a new memorandum of understanding has been negotiated with the Mills-Peninsula IPA." And the San Mateo IPA is currently negotiating a new contract with the orthopedists, according to Lisa Kraymer, the IPA's CEO, though, "she said there is little room for negotiation." Voicing similar protests, surgeons from Santa Clara, Marin, San Francisco and the East Bay, have also inquired about joining the coalition, Zacharia said. He also said the doctors are forming their own IPA and may cut out the middleman by contracting directly with the HMOs. Zacharia said the issue is about "appropriate care," not about making money. "Things have gotten really twisted. The MBA types have gotten their meat hooks into us," he said (Simon, San Francisco Chronicle, 7/9).