Primary care is in trouble. Doctors are banding together to increase market power

"Valley has 90 medical providers including doctors, nurse practitioners and physician assistants and on-site labs, x-rays, and vision care. With tens of thousands of patients, it's become one of the largest independent practices in western Massachusetts. It forms a key part of the region's health care infrastructure yet Valley Medical has rarely been under more strain than it is now."

"Valley Medical Group is far from alone in this predicament. Thousands of primary care practices, a key gateway to the medical system, are fighting to remain financially viable and independent. In response, many of them are banding together to form Independent Physician Associations, or IPAs. The goal is to increase their market power, change the way they get paid, and remain in control of how they treat patients."

Western Massachusetts comprises rural communities and low-income cities where many residents struggle to find a primary care doctor. Valley Medical Group operates four locations with 90 providers, on-site labs, x-rays, and vision care, serving tens of thousands of patients. The practice recently laid off 40 employees, about 10 percent of staff, mainly in support roles. Patient demand remains high, yet waiting lists persist and primary care providers face increased clinical responsibilities and relatively lower pay. Many primary care practices nationwide are forming Independent Physician Associations to gain market power, alter payment arrangements, and preserve independent control over patient care.

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