PHSO vs. MSO

The PHSO is a vehicle to connect all the dots for a transformation from the old fee-for-service to the new value-based payment models.There are many benefits to organizing and operating a PHSO to support this transition, including:

Integrating physicians with an organized delivery system of care, which supports ACO and CIN initiatives.

Creating a mechanism to aggregate a holistic view of care provided to a patient across a continuum of care and integrating that view for all providers involved in a patient’s care

Coordinating the care management services across a continuum and managing transitions of care between settings.

Providing a contracting vehicle that allows and supports providers to assume risk and manage it effectively.

Being the collaborative forum for clinicians to develop care pathways, protocols and patient-centered care management programs to bring role clarity and coordination to the many individuals who might be involved in a patient’s care.

Enhancing system interoperability to exchange and share data among providers to support care delivery,

Improving financial performance and managing the complexities of practice management.

Ensuring compliance with CMS programs, such as MACRA, and avoiding payment reductions.

Supporting consumerism by creating a unified brand focused on consumer experience and loyalty.

Managing revenue cycle and coding processes (i.e., diagnosis coding, chronic care management requirements, hierarchical condition categories/risk adjustment factor to support value-based contracts.

Providing education to physicians—both employed and independent—on topics, such as industry trends, leadership and care redesign.

Whether physicians are employed or independent, a PHSO can support them equally while providing a vehicle for improved operational and financial performance.