Primary Care Doctors Unite to Protect Independence

Struggling practices in western Massachusetts form Independent Physician Associations to negotiate better contracts and preserve autonomy.

Apr. 12, 2026 at 3:55am

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A ghostly, translucent X-ray photograph of a stethoscope, its internal structure glowing against a dark background, conceptually illustrating the delicate balance and inner workings of primary care.As primary care practices struggle to maintain their independence, an X-ray view reveals the intricate challenges they face in sustaining their vital role in the healthcare system.Northampton Today

Primary care practices in western Massachusetts, including the respected Valley Medical Group, are facing financial challenges due to low insurance reimbursement rates. Instead of selling out to hospital systems, they are banding together to form Independent Physician Associations (IPAs) to regain control and negotiate better contracts with insurers. This controversial move aims to preserve physician autonomy and secure the future of independent primary care in the region.

Why it matters

The survival of primary care is under threat nationwide, with an estimated shortage of 86,000 doctors by 2036. Practices are closing or merging with hospital systems, compromising physician autonomy. The formation of IPAs by independent practices like Valley Medical Group is a bold attempt to reclaim control and ensure the long-term viability of community-based primary care.

The details

Valley Medical Group, a respected primary care practice with four locations in the Connecticut River valley, has been grappling with financial challenges. Despite a patient waiting list, the practice was forced to lay off 40 employees, 10% of its staff, due to inadequate insurance contracts and rising costs. Rather than sell out to a hospital system, Valley Medical Group has chosen to join an IPA, a union-like organization that empowers primary care offices by negotiating contracts with insurers. This approach aims to regain financial stability and preserve the practice's independence, allowing doctors to make the best clinical decisions for patients without the influence of hospital systems.

  • Valley Medical Group laid off 40 employees in early 2026 due to financial pressures.
  • The practice is now joining an Independent Physician Association to negotiate better insurance contracts.

The players

Valley Medical Group

A respected primary care practice with four locations in the Connecticut River valley, serving as a beacon of family medicine since the 1990s.

Dr. Paul Carlan

The CEO of Valley Medical Group, who attributes the practice's financial challenges to inadequate insurance contracts and rising costs.

Dr. Lisa Bielamowicz

A representative from TrustWorks Collective, who describes the formation of IPAs as a 'moment of transition' for primary care practices seeking independence.

Lisa Glenn

A representative from Blue Cross Blue Shield of Massachusetts, who highlights the importance of supporting independent primary care practices and offering value-based contracts.

Chris Kryder

The founder of Arches Medical, an IPA that is entirely physician-owned and focused on primary care.

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What they’re saying

“We must not let individuals continue to damage private property in San Francisco.”

— Robert Jenkins, San Francisco resident

“Fifty years is such an accomplishment in San Francisco, especially with the way the city has changed over the years.”

— Gordon Edgar, Grocery employee

What’s next

Experts believe that if primary care providers collaborate through IPAs, they can build market power and make value-based contracts more prevalent. This approach could reduce unnecessary hospitalizations, save costs, and increase income for primary care providers.

The takeaway

The formation of IPAs by independent primary care practices like Valley Medical Group represents a bold attempt to reclaim control and secure the future of community-based primary care. By banding together, these practices hope to negotiate better insurance contracts, preserve physician autonomy, and ensure the long-term viability of their profession.