RELEVANT TERMS – Class 8
INDEPENDENT PRACTICE ASSOCIATIONS (IPA)
Physicians organizing as an entity for managed care contracting purposes. This IPA contracts with MCOs and/or Employer Groups on behalf of the organized physician group for a negotiated fee. Physicians continue in their existing individual or group practices and are compensated on a capitated, fee schedule, or fee-for-service basis according to the terms of the contract(s).
INTEGRATED DELIVERY SYSTEM (IDS)
Also referred to as an integrated health care delivery system. An IDS is a system of health care providers organized to span a broad range of health care services. IDS is a generic term referring to at least a joint effort of physician and hospital integration for a variety of purposes. An IDS aims to be able to access the market on a broad basis, optimize cost and clinical outcomes, accept and manage a full range of financial arrangements to provide a set of defined benefits to a defined population, align financial incentives of participants (including physicians), and operate under a cohesive structure.
MANAGEMENT SERVICE ORGANIZATIONS (MSO)
A legal entity that provides practice management, administrative and support services to individual physicians or group practices. An MSO may be a direct subsidiary of a hospital or may be owned by investors.
PHYSICIAN HOSPITAL ORGANIZATIONS (PHO)
A legal entity formed and owned by one or more hospitals and physician groups in order to obtain payor contracts and to further mutual interests. Physicians maintain ownership of their practices while agreeing to accept managed care patients under the terms of the PHO agreement. The PHO serves as a negotiating, contracting and marketing unit.
PROVIDER SPONSORED ORGANIZATIONS (PSO)
A legal entity created for Medicare and Medicaid contracting purposes combining the services of various Providers.
EQUITY MODELS
An entity created and owned by physicians for providing medical services.
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