Transcription
The New HealthcareManaged Service Organization:Just What the Doctor OrderedPresented byJames D. Swift, M.D.Chief Development Officer, MEDNAXAnn BarnesPresident and CEO, MedDatawww.mednax.com
Agenda1What is a Healthcare MSO?2Why are MSOs Important to Hospitals?3Services breakdown of MSOs4How MSOs Benefit Hospitalswww.mednax.com
1What is a Healthcare MSO?
What are Healthcare MSOs?A healthcare MSO is an organization that provides non-clinical services toproviders to enhance revenues, contain costs and improve quality.W H O T H E Y I M PA C TPractices - receive significant administrative assistance.Physicians - maintain increased level of autonomy.Patients - experience improved service engagements, economies of scale /cost savings4www.mednax.com
2Why are MSOs Important to Hospitals?
Market DynamicsINCREASING NEED FORSOLUTIONPROVIDERSPROVIDER CHALLENGESRCM/PATIENT TRENDSHealthcare reform creatingHealthcare reform creatingComplex ReimbursementChallengesOutsourcingHealthcare payment processStructured AroundInsurance ProvidersPoor collections of patientbalances:19% vs. 75%zIncreases in patientresponsibility3% 35% 50%Increased Medicaid drivingneed forOnsite Enrollment& Eligibility Serviceswww.mednax.com
What Hospital Leaders and Physicians WantPreserve clinical autonomyCreate a practice that isefficient, high quality, andpatient –centric.Patients to remain loyal to thehealth system(increasing stickiness).Solutions to their practicecoordination and complexitychallenges.Vehicles to strengthen hospitalphysician alignment .To mitigate compliance risk.To offset complexreimbursement challenges ofHealthcare reform.www.mednax.com
Building Partnership: External Forces at WorkSOLUTIONSFACED BY HOSPITALS & PHYSICIANSWANTED BY HOSPITALS & PHYSICIANS Increasing financial pressures to manage challengingmarket conditions Healthcare consumerism and the importance ofpatient experience Healthcare reform legislation Exponential growth of RAC firms Growing number of payor plan designs Greater coding complexity Lower reimbursement ratesMSO OrganizationsPROBLEMS To preserve clinical autonomy and helpcreate a practice that is efficient, highquality, and patient-focused. Solutions to their practice coordination andcomplexity challenges. Vehicles to strengthen hospital-physicianalignment. Vendor consolidation C-suite seeking to consolidate vendorswww.mednax.com
3MSO: Services Breakdown
MSO Services inical EffectivenessPhysician Referral thorizationFinancial CounselingPATIENT ACCESS & Point of Service CollectionsPatient ONCoding & Clinical DocumentationCompliance Audit & TrainingCharge Capture & ReconciliationBilling / AR Follow-UpCredentialing / Provider EnrollmentPayor ContractingComplianceREVENUE CYCLEMANAGEMENTANALYTICS &CONSULTINGPractice GrowthPatient EngagementBenchmarkingClinical EffectivenessPopulation Health AnalyticsLabor ProductivityPhysician Compensation DesignREVENUECOSTwww.mednax.com
4How MSOs Benefit Hospitals
How MSOs Benefit HospitalsQUALITYPATIENTSATISFACTIONOptimize revenue capture,procedure mix andpromotion capabilities.REVENUEProvide improvedexpertiseCOSTHelp achieve betterresults at lower costswww.mednax.com
?Q&A
www.mednax.com The New Healthcare Managed Service Organization: Just What the Doctor Ordered Presented by James D. Swift, M.D. Chief Development Officer, MEDNAX
