(305) 273-9100
As a care provider in today’s often hectic and competitive health and wellness industry, your work is really cut out for you. On the one hand, you want to improve the quality of your services, while on the other hand, you need to maintain a cost-effective way of preserving your valuable doctor-patient relationships.
On the business side of running a practice, it can be challenging to understand all the different models, programs, and contracting opportunities available to primary care providers. Nevertheless, knowing the difference between accountable care organizations (ACOs) and managed services organizations (MSOs) is important if you want to make the most of the opportunities of value-based care.
Although these models often overlap one another, they each offer their own benefits and require different types of member participation. Here is what you should know about these programs and their effect on your delivery of lower-cost quality care.
Accountable Care Organizations (ACOs)
ACOs are formed by a group of doctors or hospitals as a means of improving healthcare delivery to Medicare patients. The Centers for Medicare & Medicaid Services (CMS) created the Medicare Shared Savings Program (MSSP) a decade ago with the goal of improving performance on certain measures of quality – such as preventable hospital utilization or chronic disease management – by offering financial incentives for providers, while at the same time keeping their spending below specific benchmarks.
Provided the ACO meets its quality and spending targets, it receives a portion of the shared savings, or the difference between what Medicare expects to spend and what it actually spends on care for a predetermined group of Medicare beneficiaries.
ACOs have the option of choosing an upside only or downside risk (also known as two-sided risk) model. With an upside only risk model, the ACO receives a check for shared savings if they succeed but are not financially liable to return any money to Medicare in the event that they spend more on delivering care than Medicare expects. By accepting downside risk, an ACO could potentially earn a larger proportion of any shared savings if it meets its quality and spending benchmarks. If the ACO spends more than Medicare expects, however, it is then required to pay a percentage of the losses to Medicare.
Managed Service Organizations (MSO)
An MSO is a management services company that provides a wide range of administrative and support services to primary care physicians, from billing and coding to HR management and regulatory compliance.
An MSO can take on a variety of important back-office tasks, including:
- Payroll and human resources
- Coding and billing
- Patient collections
- Contract management
- Regulatory compliance
- Purchasing supplies and medical equipment
- Office space management
An MSO may also connect healthcare providers with electronic health record vendors, managing those technologies and relationships, as well as supplying population health analytics tools or patient engagement solutions.
By partnering with an MSO, your practice can focus on what it does best – providing quality patient care – while we efficiently handle your back-end operations. In turn, this can free up your time, reduce stress, and improve your bottom line through increased efficiency and revenue optimization.
Support for Physicians and Practices in Central and South Florida
Managing the clinical operations of a medical practice takes a great deal of time and attention to detail and can be an overwhelming task for healthcare professionals. That’s where Premier Physician Support Services can help. We take care of most health plan and regulatory compliance tasks, so you can concentrate on delivering the best possible care to your patients.
With physician networks in 11 counties in South Florida, Central Florida, and the Tampa area, Premier Physicians Support Services is one of the largest, longest running, and continuously successful MSOs in the state. We organize networks of primary care, family, pediatric, and internal medicine physicians to take risk contracts from HMOs for both Medicare and Medicaid.
To learn more about our comprehensive administrative services, please contact Premier Physicians Support Services at (305) 273-9100. Our friendly and dedicated staff welcomes your call and looks forward to the opportunity of serving you.
