"Hospitals are looking for opportunities to partner where assets aren't necessarily held by an outside company," says James Swift, MD, chief development officer at MEDNAX, a national medical group. Dr. Swift spoke at the Becker's Hospital Review 5th Annual CEO + CFO Roundtable on Nov. 8.
What do these opportunities include? Healthcare managed service organizations.
Dr. Swift defined an MSO as an organization that gives nonclinical services to providers to improve quality, boost revenue and cut down on costs.
MSOs strive to achieve four goals. "Everything we do has to hit one — hopefully all — of these buckets: increase quality, increase patient satisfaction, increase revenue and decrease cost," says Ann Barnes, president and CEO of MedData, a revenue cycle management services provider. MEDNAX acquired MedData in 2014.
MSOs hit these buckets by focusing on four service areas:
- Analytics and consulting. This includes benchmarking, patient engagement, population health analytics and labor productivity.
- Revenue cycle management. This area encompasses payer contracting, billing, credentialing, compliance, coding and clinical documentation.
- Practice administration. This includes IT, scheduling, payroll, HR, facilities management and clinical effectiveness.
- Patient access and communication. This sector encompasses registration, pre-authorization, financial counseling and patient communication.
"We're looking at what we can bring to practices in terms of changing the overhead structure," Dr. Swift says. MSOs bring promotion capabilities, improved expertise and better results at lower costs to hospitals.
But it's not only hospitals that benefit from MSOs — physicians and patients can also reap advantages. Physicians can use MSOs to maintain an increased level of autonomy and better vehicles to strengthen their alignment with hospitals. Patients may be able to obtain improved service engagements and cost savings. As Ms. Barnes pointed out, the purpose of an MSO is to ask, "Can you build a continuum where the patient experience for that health system is positive?"
"It's not getting easier to do services — it's getting more complicated," Ms. Barnes notes. MSOs make it easier to improve outcomes for hospitals, physicians and patients. "It's not an event managed program, but a whole outcome managed program," she says.