Our organization consists of Local Physician Teams (LPTs) that are contracted with HMOs through a master contracting IPA called “Linked IPAs.” This IPA is managed by MRSB Holding, LLC and sponsored by a non-profit charity called TBT. We have been in this business since 1995 and have served more than 7,000 Medicare Advantage Patients in Houston that were insured by Secure Horizons and Selectcare. We have always done so under capitation agreements for both primary care and specialty care. In the last three years we have contracted with Bravo and Wellcare. In 2010 we added Universal Healthcare.

These newly contracted HMO plans have grown slowly so that, at this time, our PCPs serve only 1,500 of their members. We anticipate that each HMO will likely enroll a few hundred more members that will come from our 125 PCP’s practices.

In the past we watched the older MA plans build from a few hundred members in the early 1990s to over 7,000 with our PCPs by 2006. During that time we found that profits of the plans and the bonuses to our physicians came from the attention of the PCPs to the patient’s acute care needs, preventive medicine practices, and management of chronic diseases. Also, the PCPs and the specialists who were on teams were paid by capitation, and had control of the clinical and hospital environments so that the quality of care was easier to monitor and maintain. Many of the physicians in the LPTs have been, and are still. paid on a fee-for-service directly by the HMOs and Commercial Insurers but Linked IPAs is contracted under a global capitation model and shares risk with the insurer so that when the plans profit from the physician’s management of the patient’s health that profit is shared with the physicians.