Primary care is struggling in the US. Many medical practices are merging with large hospital systems, which can take away autonomy and lead to financial struggles. Valley Medical Group, a large independent practice in western Massachusetts, has decided to join an Independent Physician Association (IPA) to increase market power and change payment models.
The group’s CEO, Dr. Paul Carlan, wants his doctors to have more control over their work. “When you’re part of a health system, you’re constantly being asked to bend for the needs of the organization,” he said. “Our priorities get muddled up.”
Valley Medical Group has joined Arches Medical IPA in Cambridge, Mass., which specializes in value-based contracts. This model pays medical providers based on patient outcomes rather than individual services. If successful, it could save money for healthcare systems and provide more income for primary care providers.
However, not all IPAs are created equal. Some may be owned by hospital systems or private equity companies, with less focus on preventative care. The American Association of Family Physicians advises its members to seek out IPAs with “integrity” that prioritize physician autonomy and patient needs.
Ultimately, the goal is to create a more financially stable primary care system where doctors have control over their work and can provide better care for their patients.
Source: https://www.npr.org/2026/02/16/nx-s1-5715996/primary-care-independent-physician-association-ipa-medicaid-cuts-value-based-reimbursement