Understanding MSOs
Dr. David Edward Marcinko; MBA CMP™
Publisher-in-Chief
Most medical practice management services organizations [MSOs] for doctors are organized as IPAs.
Under such plans, doctors make the rules, regulations and medical care guidelines while MSO executives (MBAs, CPAs, CFAs, PhDs and JDs) administer those policies. Centralized data is collected and the organization is responsible for utilization review, quality control, and eligibility verification and payment.
Definition
The MSO is more of a broker, who works for the physicians in the plan, marketing, selling and running it on a daily basis. This leaves the MD’s unfettered to provide patient care; for a price that is typically 10-18% of net patient revenues, per month.
Practitioner Candidates?
A medical practitioner may be a candidate for a MSO organization if s/he possesses most of the following characteristics:
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excellent medical education,
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good business background,
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honed management and leadership skills,
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practices in a large multi-doctor group with rising net income,
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uses current HIT systems,
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has gross margins exceeding fifty percent,
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provides ancillary services such as a wound care or ambulatory surgery center,
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is under 45 years of age, and;
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desirous of practicing medicine in the future.
Assessment
Finally, the provider should have some business savvy and practice in an area with relatively weak MCO market penetration.
Any provider should also consider joining a MSO if his future professional outlook is optimistic and positive.
Conclusion
And so, what has been your experience with MSOs, if any?
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Filed under: Managed Care | Tagged: Managed Care
MAPS
Did you know that Medicare Advantage Plans [MAPs] will see payment rates increase by 3.6% in 2009, slightly higher than last year’s rise of 3.5%, but not as much as the 3.7% boost previously predicted.
This slight drop from earlier estimates is a result of lower-than-expected plan expenditures for 2007, according to analysis by the Centers for Medicare and Medicaid Services (CMS).
-Staff Reporters