Over the past five years, there has been an unprecedented surge in the number of cyber-attacks in the healthcare industry.
In one attack recently, hackers compromised more than 78 million insurance records kept by Anthem. They gained access to highly sensitive data as well as the names, social security numbers, home addresses, and birth dates of patients.
Because healthcare organizations collect and keep massive amounts of personal information from patients, they will continue to be cyber-crime targets. What's the best way to secure precious patient information?
For many healthcare organizations, the first line of defense should be an MSO healthcare company. They can help you ensure that transactions are streamlined and secure.
Continue reading to find out more about the functions of a managed services organization.
What Is an MSO?
Let's start with a simple question. What is an MSO in healthcare? It refers to an organization that offers healthcare managed services to providers. These services enhance revenues, contain costs, and improve quality of care.
MSOs may be owned by hospitals or non-healthcare provider investors. They could be owned by groups of physicians or represent a joint venture between physicians and a hospital.
Some health plans even own them. But they all perform the same basic functions.
They step in to handle the heavy lifting when it comes to things like payroll, human resource issues, and benefits. They also effectively manage revenue cycle management and coding compliance.
They can even help with pricing services and supplies. In other words, they're a one-stop-shop for all of your medical management needs.
MSOs provide medical practices with significant administrative assistance. Their services help physicians remain autonomous.
And patients enjoy the side benefits associated with MSOs. These include cost savings, economies of scale, and improved service engagement.
What Can an MSO Do?
Besides financial management, HR and personnel management, and basic operational issues, MSOs can handle all of your billing needs.
They can also tackle:
- Coding, billing, and collection services
- Staff education and training
- Discounts and provisions of medical equipment
- Integration of electronic health records (EHRs)
- EHR software management
- Providing and managing office space
- Credentialing and contract management
- Risk management
- Savings with group purchasing
- Regulatory compliance and oversight and management
As a result, they are uniquely positioned to benefit from economies of scale.
From healthcare insurance to medical equipment, they enjoy preferred pricing on a variety of services and supplies. Some can also offer discounted EHRs because all of their members use the same platform or vendor.
What Are the Different Types of MSOs?
There are two different types of MSOs. The first are MSOs that manage the tangible assets of practices directly and own them outright.
For example, the MSO owns the supplies, equipment, and office space that physicians then lease from them. Physicians still retain possession of their staff, medical records, existing insurance plan contracts, etc.
There are pros to this arrangement. Physicians get to work from their existing office space. But they no longer have to worry about administrative expenses or the hassle associated with managing these assets.
But there are also cons to this setup. Physicians lose some of their autonomy. As a result, they may find it difficult to part ways with an MSO down the road.
That said, the benefits outweigh the negatives. Especially if you're looking for a streamlined way to practice medicine without administrative headaches. You'll also rest assured your patients' records remain safe and secure.
In the second MSO model, the physicians remain in control of much more. The MSO provides business services as needed. But the physicians work independently of the MSO in many instances. They also own their administrative assets outright.
Of course, this means more administrative issues for physicians to tackle. This takes away from their ability to focus on their practice and represents a far less beneficial model. Although one prized by those who value autonomy above all else.
How Are MSOs Evolving?
The administrative demands placed on physicians and medical practices continue to expand almost exponentially.
Physicians today report spending less than 27 percent of their time with patients and more than 49.2 percent on paperwork. Two-thirds of their time is being eaten up by administrative functions.
Paperwork has become overwhelming. Fortunately, MSOs are evolving to fill more roles and relieve some of this burden.
As more insurers are tying reimbursements to outcomes and quality, MSOs are also grappling with the growing demands of a value-based marketplace. They're taking on tasks such as tracking performance to meet clinical metrics and measures.
Some MSOs are offering care coordination services, developing standards of care and clinical guidelines, and fully integrating members clinically. That way, they can take advantage of shared savings from insurers and upside bonuses.
What Do You Need to Understand About MSOs?
As with any contract for services and products that you're about to enter into, you need to understand the contract and its terms thoroughly. You also need a contingency plan should the MSO arrangement not prove suitable.
In their agreement, the MSO should enumerate the services and deliverables that they'll be providing. There should be no questions in your mind about what you'll be receiving.
Make sure you have a thorough understanding of the services offered and any limitations associated with them. For example, some MSOs may bill and collect from insurance companies. But are they willing to do the same for patient collections?
Know exactly what you're getting into before signing anything. But don't stop there. You also need to know what it requires to terminate the agreement.
This includes knowing how much notice you need to give before terminations as well as what you'll have to do to regain control of your billing operations and to buy back assets that you may have sold to them.
Is MSO Healthcare Right for Your Organization?
MSO healthcare organizations provide physicians and practices with an ever-evolving depth and breadth of managerial services. These help streamline administrative functions, billing, much more.
MSOs can also reduce administrative costs and guarantee the security of online assets.
Finally, they can assist with purchasing and a variety of other functions. An MSO could revolutionize your practice. Just make sure you carefully review any MSO agreement that you receive before entering into a contract.
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