By RaeAnn Grossman
There are so many acronyms in healthcare. It is hard to keep them all straight. When you think of starting or managing an IPA, ACO, MSO, medical group, or physician practice, there is a lot to do. You need to think about care delivery, legal structure, goals around care and cost, human resources, coding, billing, location, payer relationships, and the patient experience.
Let’s review all that an MSO does:
- Clinical operations
- Financial management
- Human resources and personnel management
- Staff education and training
- Coding, billing and collection services
- Managing office space
- Discount and group purchasing (EHRs and medical equipment)
- Regulatory compliance support and oversight
- Contract negotiation and management
- Risk management
Types of MSOs:
Although there may be several, the two main types are:
- Independent business services and management
- Owned practices and management
Each can vary in their relationship with health plans by offering cost-savings, quality incentives, premium capitation, delegated care management, disease management, utilization management, delegated credentialing, and claims payments.
As physicians think about which IPAs, MSOs, and ACOs they want to be a part of, they should talk through the current structure, vision, goals, impacts, care delivery models, and lessening administrative burdens.