New Practice Start-ups

Terminology changes in healthcare just as fast as the guidelines do. First a bit of history.  If you think back about twenty years ago, the term HMO was first hitting the scene with a scramble to learn more about this new insurance product, which has now turned into the biggest heartache in our staff productivity and cash flow.  Then about ten years ago traditional medical billing services were "rebranded" as revenue cycle management (RCM).  As this term has developed so have the differences in medical billing and RCM, with true RCM being the management of the revenue cycle versus just the action of submitting and collecting on charges.  About five or more year ago, this term MSO started to pop up in the market with every healthcare service company jumping on the MSO bandwagon.  As this term has developed, now an MSO is a corporation that runs medical practices.  They offer to handle select or all aspects of your practice, "releasing" you of the day-to-day operations, however this also means relinquishing decision making and control over the business aspects.  This maybe an over simplified definition but encompasses the majority of situations.  

An MSO handles everything surrounding the business of medicine.  The services that flow through a management service agreement typically include revenue cycle management, EHR implementation, facility leasing, HR administration/staffing, marketing, payer relationships, IT infrastructure, financial reporting, purchasing, and strategic development.  The physician-owned professional entity retains the practice of medicine.  
 

For small and mid-sized independent practices that want to grow, this approach sounds appealing when facing the challenges of growth and the time involved.  Often times, a small practice cannot afford a full revenue cycle team or practice administrator, a compliance officer, nor do they have the time to focus on growth areas.  An MSO offers to spreads those costs across many other practices at a reduced cost.  
 

MSOs are usually hospital systems or private equity-backed platforms have institutional capital. An MSO partnership with real capitalization offers to change that equation, letting a group invest in growth without selling the practice or accepting employment, however a practice should consider why they are in private practice and the repercussions to losing partial ownership or business decision making.  What makes private practice the best form of healthcare delivery is that it is operated by those delivering the care and not only on the sole focus of driving an EBITDA (measures a company's core profitability).  

For some, an MSO is a perfect solution, and Evolution provides services to existing MSOs, for others, they take advantage of a vendor relations with Evolution to accomplish the same goals in-house.  While it is vitally important to watch profit so a practice can stay in business and grow, the same structure that offers to preserve independence can be often times eliminate it.  It is possible to accomplish your goals while maintaining control. 

Evolution is NOT and MSO. We offer just about all the services one would expect to access through an MSO, have the experience to be an MSO, and even provide services to some MSOs as a vendor, we stand firm that when medical providers own and facilitate the management of a medical practice, it is a win for patient care, a win for provider satisfaction, and a win for competition in the healthcare marketplace.  

Evolution is a vendor.  We are designed to support private practice and existing MSOs by providing access to needed high level services that assist with the mission, desires of the practice, and growth.  These services are offered ale cart, as needed, with a temporary price compared to a full-time salary or long-term operation agreement.

The administrative burden in medicine has expanded dramatically.  A small practice often times does not need full-time services but needs differing levels of supplemental consulting assistance to project plan and get on the right path.  From that point, they can manage the day to day from that point forward.  If independent practices want to grow, through adding providers, opening additional locations, implement technology, and build out ancillary services, banks and lending institutions also want to support private practice.