UPA Represents The Next Generation of Physician Group Legal Structures
Since the early 20th century, physicians have grouped themselves together both physically and legally in order to provide better care and have better control over their business operations.
Out of this need grew four major physician group models (two of which are single group models, and two of which are multi-group affiliations).
Single Group Models
Traditional Small Group Practice
A group of doctors agrees to become partners in a practice under the same brand name. Physician autonomy is high, but there is relatively little leverage when negotiating with insurance companies and vendors.
Example: Your neighborhood practice
Single Taxpayer ID
A much larger group of doctors all agree to become partners in an institution under the same brand name. Physicians are now employees of the group and have lost some autonomy, but there is considerable leverage when negotiating with insurance companies and vendors.
Example: Mayo, Kaiser
Affiliations
Third Party Messenger Model
A group of disparate medical practices agrees to designate a common entity to collect information from each member practice. The entity can give and receive information about health insurance contracts to each member, but the members cannot discuss this information among themselves. The entity is legally limited from growing beyond 25% - 30% of a local healthcare market.
Example: PHOs, IPAs, "Unionization" attempts of doctors by the AFL-CIO
Physician Advocacy Groups
A group of physician advocates organizes in the hopes of effecting change in the local or national community in which physicians practice. There is no real business power, but the group provides for high physician autonomy and gives physicians a voice.
Example: AMA, ArMA
How the UPA Model is Different
UPA represents the next generation of physician group models. Although a single group, UPA brings to the table desirable elements of the affiliation models to preserve, to the extent possible, physician autonomy. A goal of UPA is to allow physicians under a single tax ID number to maintain the highest physician autonomy that is legally and operationally possible. Physician members have a low upfront cost of participation, an opportunity to evaluate whether UPA is right for them, and the option to leave at any time at no cost. However, as a single multispecialty group practice, UPA is able to maintain leverage when negotiating with insurance companies and vendors.
To accomplish the goal of leveraging great physician numbers in order to negotiate with large corporations, by design, only a single group model could succeed. The challenge is to gain the benefits of a single taxpayer ID group without losing autonomy.
| Cost of Participation | Physician Autonomy | Business Leverage | Physician Advocacy | |
| Traditional Small Medical Group | Low | Very High | Low | None |
| Single Taxpayer ID | Low | Low | High | Moderate |
| Third Party Messenger | Moderate | Very High | Moderate | Low |
| Physician Advocacy Groups | Low | Very High | None | High |
| UPA Legal Structure | Low | High | High | High |
A Significant Percentage of Physicians in Your Market Can Be Members of UPA
Many physicians are familiar with anti-collusion laws that prevent doctors from banding together into large loosely affiliated groups and/or sharing data between groups of doctors. UPA provides a legal avenue where physicians can work together, both for the benefit of physicians and patients.
UPA has been designed to allow a significant percentage of physicians within the "healthcare market" to participate. Legally the "market" could be the entire country. UPA is inclusive; so as long as a physician is qualified and cooperative, the physician is welcome and may join.
Physicians Retain Substantial Autonomy
Physicians who enter UPA do so within a division. A great number of divisions are possible within the UPA structure. Typically, each physician practice or group can enter as its own division. Divisions are largely autonomous, but not completely so. Infinite autonomy is not possible within a single group. UPA has been designed to allow for the greatest possible autonomy for its physician members that is clearly within legal guidelines.