River Valley Physicians, Inc., (RVPI) is a local/regional management services and group purchasing organization currently serving pediatric and other independent primary care practices in and around Greater Cincinnati/ Northern Kentucky/Southeast Indiana. RVPI has partnered with community physicians since the 1980s. RVPI offers to its member practices not only top level discounts for Sanofi and Merck vaccines but a wide variety of other discounted products and services, including, but not limited to, med-surg supplies, office products and professional liability insurance. In addition, the organization provides educational programs for physicians and practice managers as well as consulting on practice management issues. The organization’s relatively small size versus the larger GPO’s enables it to provide a personal touch with member practices. Network members feel the freedom and easy access to call with questions concerning operational issues, government regulations, etc. RVPI might be described as part GPO, part MSO, and even part IPA (through the work of many practices in its network promoting quality and cost effective care in a relationship with Cincinnati Children’s Hospital Medical Center). It does not consider itself as competing with typical nationwide GPOs; instead, RVPI expects its growth to come predominantly from the Tri-State area.