New multispecialty advocacy group wants to protect independent practices from hospitals' buyouts

A new national, multispecialty advocacy organization representing independent practices launched last week.

The American Independent Medical Practice Association (AIMPA) says it is the first advocacy organization of its kind focused on supporting private medicine across specialties. It is made up of 5,000 physicians collectively treating 10 million U.S. patients and includes specialties ranging from cardiology to gastroenterology to medical oncology to OB-GYN and more. 

The group does not yet include a primary care doc, though AIMPA executives said they would welcome the opportunity to work with them.

AIMPA's formation comes amid growing consolidation in the healthcare sector. Between 2012 and 2022, the share of physicians working in private practices fell by 13 percentage points from 60% to 47%, according to one estimate. In the same period, the share of docs working in hospitals as direct employees or contractors increased from 6% to 10%. The share of docs working in practices at least partially owned by a hospital or health system increased from 23% to 31%.

"Big hospital chains have increasingly acquired physician practices over the past two decades—and contrary to hospital executives' promises, that consolidation has not led to better care or lower costs for patients," Paul Berggreen, M.D., board chair and president of AIMPA and founder and president of Arizona Digestive Health, said in a press release. "The hundreds of thousands of doctors working tirelessly at independent medical practices across the country offer patients a more attractive alternative. And we're excited to be their voice in Washington."

AIMPA founding member organizations include Capital Cardiology Associates, Gastro Care Partners, OneOncology, Platinum Dermatology, Solaris Health, Unified Women’s Health, U.S. Urology Partners and others. Its members represent nearly 200 medical practices providing healthcare in 39 states plus Washington, D.C. 

AIMPA Vice President David Eagle, M.D., chair of legislative affairs and patient advocacy at New York Cancer and Blood Specialists, stressed the importance of independent practices in expanding access to high-quality, cost-effective care in communities around the country.

“We’re value-based care hidden in plain sight,” Eagle told Fierce Healthcare. 

New York Cancer and Blood Specialists, Eagle’s employer, takes every insurance plan and offers significantly cheaper cancer care than competitors in the state, Eagle said. It encourages patients to come in with or without an appointment and has put clinics in underserved communities where other organizations may not want to go, he said. Its foundation has also raised $1 million to address social needs for patients.

AIMPA’s goal is to educate lawmakers and advocate for policies that help protect the private model and help it remain a strong alternative to care provided by hospitals and health systems.

Eagle said reimbursement disparities between hospitals and private practices are a major point of contention. While hospitals get inflation adjustment and higher revenue from commercial contracts, private physician reimbursement lags. Over the last 20 years, shrinking Medicare reimbursement rates for physicians have strained many small, independent practices, according to the American Medical Association.

A consequence of higher negotiated commercial rates at hospitals as well as consolidation, Eagle said, is that costs go up for patients and for healthy people.

Eagle believes that to date, the private model has been ignored in part because of hospitals’ market power and in part because of policy choices. An example of a bill like the ones AIMPA hopes to advocate for is the recently introduced Strengthening Medicare for Patients and Providers Act, which would provide inflation adjustments to doctors similar to those hospitals get, Eagle said. 

“We’re not asking for anything more than anybody else,” Eagle said. “We fundamentally just want a level playing field.”