If the MSO needs more capital to cover the purchase of information systems and other start-up costs, the hospital can deliver that capital without affecting the MSO's governance or ownership rights. Additional capital can be loaned to the MSO in the form of debt, but the MSO must repay the debt with interest before making a distribution to the MSO owners. How It Happens Physicians form a group. Although group members are most likely to be primary care physicians, they can also come from the ranks of subspecialists. Creating a group with a single tax identification number, as detailed below, facilitates physician involvement in governance, enhances managed care contracting clout and creates a platform for improving clinical outcomes through shared information systems.
Physicians find a hospital partner.
In this step, physicians ideally focus on a potential hospital partner where most physicians' patients are hospitalized. Most commercial managed care plans budget dollars equally for the hospital component of a premium as the combination of the premium dollars allocated for the professional component of primary and subspecialist physicians. Participating in risk pools that cover both the hospital and physician components is important to clinical management and economic reward. Physicians create a new organization. Physicians create a single tax identification entity and transfer title during the initial capitalization and start-up.