Independent practices are steadily disappearing as more physicians move into larger health systems. The share of physicians in private practice fell from 60% in 2012 to 42%, according to the most recent data.
For health plans, that shift carries a cost that rarely shows up on a report. Every independent practice absorbed into a hospital system has established point-of-care workflows and gap-closure relationships that a payer must rebuild. That usually happens through a slower enterprise IT process, often with a competing payer’s programs already embedded in the system’s workflow.
Preventive care performance, Star Ratings, HEDIS measures and cost-trend management all run through the independent provider network, whether or not a plan has built the infrastructure to reach it well.
This whitepaper makes the case for treating that network as a managed, connected asset rather than a collection of one-off outreach efforts. It also outlines what plans need to put in place to act on it while the network is still large enough to matter.
Learnings include:
- Why independent practice associations and ACOs raise the stakes on payer-provider connectivity without solving the underlying problem
- How EHR fragmentation leaves most plans’ independent provider networks underused
- Why connectivity alone isn’t enough, and how pairing data access with point-of-care insight and gap closure support turns access into action
- How to extend quality and risk adjustment programs beyond the practices a plan can reach todayv