We also use our experience with MSO legal agreements to help clients navigate the arena of fraud and abuse, including bans on self-kickback, self-recommendation and fee splitting. Complex regulatory requirements require tightly structured MSO agreements. Thus, both parties must ensure that the anti-kickback law of the Federal Confederation is not violated. Does the ownership of the vocational training facility or the provision of services on behalf of that institution affect the full-time employment of physicians or the existing medical practice, if any? It is always important to check all employment contracts to verify non-competition and other restrictions. Many MSOs will also ask physicians to put in place a non-competition regime that needs to be carefully considered. Growing pain in your health practices or in your health care company? We have many clinical practices and health companies come to ask us how to reduce the risk of anti-kickback and […] Economies of scale: The centralization of administrative and administrative functions across the enterprise increases efficiency and standardizes services, while creating a economies of scale per member per month (PMPM). By creating scale scales, an MSO encourages the health system to seek partnerships that increase membership and reduce PMPM administrative costs. Incentive for network development: For health systems interested in developing their network of suppliers, an MSO can be an incentive to attract potential partners. A robust MSO is attractive in the market because it allows the provider to focus on quality clinical care without management and management functions. In addition, effective MSO services for the management of health and population care can reduce their use in areas that have traditionally been critical to the cost-effectiveness of the health care system or hospital profitability (i.e., hospital days and amenities). As part of cost modeling, companies should check the estimated revenue potential of providing effective care management services and the organization`s ability to negotiate a higher percentage of member premiums with MCOs, taking into account the cost of reducing usage in current royalty reimbursement models. There are many possibilities when it comes to working with MSOs. Some firms even contract with multiple MSOs for different needs to keep costs low.
The extent to which a practice relocates tasks depends on a variety of factors, including the size, scope of services and specific operational objectives. The good news is that there is no one-way approach – contracts with MSOs can be streamlined to meet their specific needs. Physician-led MSOs should share the practice`s objectives in providing quality patient care. From a business perspective, they will focus on pooling resources to support revenue growth and cost reduction practices. Practitioners should consult with their corporate advisors to ensure that the partnership works to its greatest benefit. Firms can also contact the MSO to provide additional services, including staff training, human resources management, compliance oversight and general risk management. As insurers increasingly condition reimbursement on quality care and outcomes, physicians can feel the burden of tracking their performance and providing measures, in addition to the administrative tasks they already have.