Management Services Organizations (MSO) are business organizations that provide the necessary administrative infrastructure, scale and technology for risk bearing organizations to function successfully in their relationships with contracted payers and regulators.
What does MSO stand for in pharmacy?
Employing a medication safety officer (MSO) can be a powerful way to protect patients from adverse drug events and take medication management to the next level.
What is Msos medical?
An Introduction to Building a Management Services Organization (MSO) | Blog | Cope Health Solutions Introduction & MSO Background A management services organization (MSO) is a health care specific administrative and management engine that provides a host of administrative and management functions necessary to be successful in the ever changing healthcare environment.
As risk begins to shift from health plans to providers as part of managed care arrangements, many of the functions and services traditionally owned by health plans, including clinical outcomes, are now more appropriately owned and operated by the health system itself. A MSO is a gateway to helping providers apply a population health lens to their practice with a focus on quality and outcomes, which ultimately, enable the practice to better control overall medical spend.
MSOs, and the functions they provide, come in many shapes and sizes. The governance, structure and functionality of a MSO is unique to the risk bearing entity, such as a health system, IPA (and in California Restricted Knox Keene entities) or medical group it is designed to serve.
- A risk-bearing entity can design or outsource a MSO for a single function/service or many functions/services depending on their needs.
- A detailed analysis is necessary to assess market need, organizational readiness, existing infrastructure (including IT), redeployable resources, current vendor contracts and organizational readiness.
Other considerations, such as operating in a multi-payor environment, can add to the complexity and require additional assessment and planning. The purpose of this article is threefold:
Explain the rationale for creating a MSO as part of health system redesign Describe the critical components of a MSO Share key considerations and critical success factors for building a MSO
Rationale for Building an MSO Building a MSO is advantageous to a health system in several ways: Improved quality and cost: A centralized care management office, as part of a MSO, standardizes care management delivery across the enterprise. Member identification, risk stratification, attribution, care management delivery, care management staffing and population health reporting and analytics are all streamlined with a common governance structure.
Centralized performance improvement and quality improvement enables consistent evaluation and course correction across the network. A MSO providing these services is positioned to realize a true opportunity to improve utilization. Economies of scale: Centralization of administrative and management functions across an enterprise increases efficiency and standardizes services while creating an economy of scale on a per member, per month (PMPM) basis.
By creating economies of scale, a MSO incentivizes the health system to seek partnerships that will increase membership and reduce PMPM administration costs. Incentive for network expansion: For health systems interested in expanding their provider network, a MSO can be an incentive to attract potential partners.
- A robust MSO is market-attractive as it enables the provider to focus on providing quality clinical care without the burden of administrative and management functions.
- Multi-payor managed care arrangements: Health systems that operate in competitive, multi-payor environments can benefit from moving administrative functions away from the health plan and into a MSO.
Owning the administrative and management functions enables greater control over medical spend. Additionally, a payor agnostic and firewalled MSO can provide assurances to managed care organizations (MCOs) during contract negotiations and can help maximize the percent of global risk, including potentially capitation, the risk bearing entity will have access to.
Critical Components of an MSO As introduced previously, MSOs centralize the administrative and management functions of health systems or practices to leverage resources efficiently and allow providers to focus on providing quality clinical care to patients. MSOs provide a variety of services that risk bearing entities can buy in totality or piecemeal, based on their sophistication and need for the services and expertise a MSO may provide.
Services typically provided by a MSO can be grouped into three main categories with multiple sub-services within each group, as shown in Image 2 below, 1) Strategic and Administrative Services, 2) Clinical or Operational Program Design and 3) Clinical decision support and Technology Enablement Service. MSOs are not required to provide a specific set or minimum number of services, however MSOs commonly take responsibility for utilization and care management, financial, actuarial and administrative services (i.e. claims management), information systems support, network development and quality reporting and improvement.
- Centrally managing or prescribing minimum standards for delegation to partners for services like utilization and care management or the provision of clinical guidelines allows MSOs to standardize services across a health system or other risk bearing entity.
- This in in turn may enable the risk bearing entity to negotiate for a greater percentage of premium dollars with health plans.
Key Considerations for MSOs MSOs can be built or may evolve from existing departments or services within a health system, medical group, IPA, Medicare Shared Savings ACO or other risk bearing entity. The decision to build or purchase MSO services should be informed by a larger strategy to gain market share, increase revenue, improve profitability on risk business and/or fill a need for central infrastructure to manage administrative services or population health.
There are several key inputs to understand prior to determining what services to build and which to buy from other MSO providers, including market need and readiness, existing infrastructure available and organizational readiness to scale and provision services to contracted providers. Medical groups, IPAs, health systems and other risk bearing entities in need of MSO services typically issue requests for proposals or information to which MSOs respond and bid to be the provider of services.
As with any strategic decision or new service, diligent research and planning should be completed prior to building a MSO or deciding to provide MSO services to another entity. Detailed cost modeling to estimate implementation costs, the potential to restructure, scale and redeploy resources and profit and loss estimates should be developed using any claims or expense data available.
In addition, effective MSO services for population health and care management may reduce utilization in areas traditionally key to health system or hospital profitability (i.e. inpatient days and admissions). As part of cost modeling efforts, organizations should review estimated revenue potential from providing effective care management services and the organization’s ability to negotiate with MCOs for greater percentages of member premiums, balancing this with the cost of reducing utilization under current fee-for-service reimbursement models.
Key Takeaways MSOs provide a wide range of administrative and management services to providers that can standardize services across organizations, reduce duplication of services and allow small practices to have access to services it may otherwise be unable to provide.
- Because of the variety of MSO services that can be offered, it is critical to understand the network need, scope and costs of services prior to building or purchasing MSO services.
- As health care continues to transition from fee-for-service to value-based payment models, the ability to leverage MSO services to standardize services and manage populations may help both small and large practices succeed.
About COPE Health Solutions COPE Health Solutions is a national health care consulting firm with expertise in value based payment and population health management strategy for clients across the health care continuum, including hospitals, health systems, medical groups, IPAs, ACOs, CINs, self-insured employers and both regional and national health plans.
What is the use of MSO?
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What does MOC stand for in pharma?
Management of Change: Every Plant for Itself! Pharmaceutical manufacturing professionals today can depend on one thing: constant change. Corporate focus may change to a new product or a new delivery method, and Lean Six Sigma programs may change established ways of doing things.
- There may be changes following a merger, or a shift to new materials and equipment.
- Many drug companies don’t keep track of the number of document control or quality assurance changes they make.
- At the typical pharmaceutical facility, depending on type and size, changes can range from about 30 to 160 per month.
All this change must be managed if its randomness is to be removed. The goal of formal Management of Change (MOC) programs is to develop an approach that will require the least expenditure of time, effort and money. First, a basic requirement and strategy must be established.
- Unfortunately, many QA managers at pharmaceutical companies are not familiar with MOC and some do not understand Quality Control, as the term has evolved in other industries.
- Often the emphasis is on firefighting and crisis management.
- In one case, a drug manufacturer had finished product that could not be shipped.
Analysis traced the problem to lack of change control in batch records. Changes never caught up with training or SOPs. FDA has yet to issue a guidance document on change management. However, the U.S. Occupational Health and Safety Administration (OSHA) offers a useful model for pharma companies that can be applied broadly to managing change.
Establishing written procedures and documentation for all changes Documenting the purpose of each change Reviewing each change for impact on safety, health, environment Authorizing the implementation of the change Reviewing additional risks introduced into the process Setting a timetable for when temporary changes are to be removed or reevaluated Updating process safety information Revising or developing new operator and maintenance procedures as necessary Training all employees and contractors who are affected by the change Maintaining the configuration of the plant.
FDA regulations 21 CFR Part 211, 21 CFR Part 600, and 21 CFR Part 820 do not explicitly require change management. However, there is the implicit dictate to manage changes that affect a process, since they can inadvertently introduce new hazards or compromise safeguards that were built into the original design of the process.
If one thinks about it, management of change is the foundation of cGMPs. It is the control function that serves as the main interface between the document control system and the management system. Its primary role is to deliver information to enable timely response. Well-conceived MOC procedures and a change control system will help to sustain compliance and improve delivery time.
This requires that documentation and communciation keep up with changes, training keep pace with job function changes, procedures be updated to reflect changes and safe work practices and health standards be reviewed for impact. Any proposed changes to existing facilities must be analyzed to determine their interaction and effect on the original design and on process safety.
- Based upon that analysis, appropriate action must be taken for all affected processes, equipment and procedures before the change is implemented.
- As the change control mechanism, MOC underlies all other processes and includes the final authorization of all proposed changes.
- In order to make change control effective without being burdensome and time-consuming, the actions required must be carefully worked out in detail and must include quick response for critical changes.
Data are collected from various plant operation sources, analyzed in the MOC system, and converted to information. This information can then be acted on by management. Configuration management is an integral part of MOC. It determines how the “configuration,” or make-up of the facility, equipment and process, is handled.
Top management must appoint a manager dedicated to MOC. However, a change control board, headed by the configuration manager, should manage the configuration and control changes. Its mission is to determine whether a proposed change will affect the configuration’s form, fit or function. Board members should include operations and maintenance professionals.
Four basic elements comprise a configuration management system.
Identification – Identifying the equipment or facility and documentation. These documents include a technical baseline, drawings, procedures, process and information diagrams, equipment data sheets and forms. Control – Baseline design and the collection of documentation used to capture a proposed change. Documentation includes security, change proposal number, review/approval authority, issuance/distribution, issued date and effective date. Status Accounting – Recording and reporting of any changes to the documentation, including history files, tracking and closure. Verification – Ensuring that the Management of Change system functions as designed and the change matches the documentation, as well as performing system audits.
MOC and Continuous Improvement Changes to process, equipment, procedures, technology, material and organization are necessary for continuous improvement and a MOC system must also be continuously improved. The process requires eight basic steps:
Identification Documentation review Change proposal Change classification Implementation plan Installation Verification Closure
Applying these steps, the system can be designed for managing the configuration and controlling the change, and then the necessary procedures and forms can be prepared. It is important that the system design come first. Specifically:
Identify the change to be made Accumulate and review the baseline documentation, including drawings, procedures, P&IDs, equipment data sheets and MOC forms.
Prepare a Change Proposal The change proposal is the vehicle used to document the changes in the specific application area. It is assigned a change proposal number, identifies approval authority, defines security, establishes issued date, effective date, and distribution.
- The baseline configuration and documentation are verified.
- From this point on, the change proposal must be controlled throughout the lifecycle.
- Classify & Approve Proposed Changes The Change Control Board must review, evaluate, and approve changes and then classify the change as normal, urgent, emergency, or temporary.
In some cases, changes which are low-risk and low-cost may be approved by the Configuration Manager. Develop An Implementation Plan The implementation plan describes how the change will be put in place. Baseline documentation is updated. Operators and maintenance personnel are trained in the change.
Install the Change This step speaks for itself. Verify Installation
Track the status of the change. Verify that each step in the process is completed and the documentation matches the “as-built” configuration. Conduct a system audit. Close Out the Change Everything is completed and the cycle is repeated for the next proposed change.
Managing change requires that the purpose and justification of the change be documented; change be reviewed for impact on safety, health and environment; cGMPs be reviewed for impact on GMP values; additional risk is not introduced into the process; authorization be documented; process information be updated; operating and maintenance procedures be revised; personnel who are affected by the change be trained; and configuration of the plant be maintained.
Sometimes changes can introduce new hazards or compromise safeguards built into the design of a process. Situations may occur that require an immediate change to protect the health and safety of the employees, facility or community. Immediate changes should have their own procedures that list steps to be taken and requirements.
Ensuring Training and Procedures In An MOC Program A large part of Management of Change is maintaining up-to-date documentation. Situations occur where personnel are not aware of changes to documentation that could indicate training does not keep pace with changes in job functions. Typical problems include not being aware of changes in training or procedures, not maintaining up-todate documentation, and lack of a detailed procedure that describes the MOC process.
In order to eliminate these problems, corrective or preventive actions may be necessary, such as: auditing the training program and/or the procedure program for deficiencies; making training part of the MOC program; developing a detailed procedure that describes a process for initiation, review and approval; and documentation, training in change, and implementation of any changes.
The lack of agreement between training and procedures is a major industry problem, especially in a regulated environment. The question becomes which is correct — the training or the procedure? Training in change is required for all changes in process and operation; technology; facilities and equipment; and procedures.
It may be as simple as reading and initialing simple changes in a procedure if it does not affect skills or knowledge. In other cases, it could require developing new lesson plans to teach the new skills and knowledge, or developing and delivering structured on-the-job training.
- Reinforcement training, an FDA requirement, is targeted for performers to maintain their skills and knowledge.
- Training in change should be critical and may cover much of the reinforcement training.
- About the Author John W.
- Rohrer is director of marketing and a field performance analyst for the Interlock Group, a performance improvement company.
He is also a certified Six Sigma Yellow Belt and Quality Auditor. : Management of Change: Every Plant for Itself!
What is the full form of MC in healthcare?
Origin: Acronym/Abbreviation – MC stands for Medical Certificate. MC is always used as an abbreviation for Medical Certificate.
What does MOC stand for in healthcare?
Model of Care (MOC)
What does MDM mean for doctors?
Medical Decision Making (MDM)
- June 30, 2019
Medical decision making (MDM) refers to the process clinicians use to make decisions and draw conclusions from any available medical data. There are many steps involved in a complete MDM process.
- The clinician interprets available patient data, including symptoms, test results, patient self-reporting, his or her own observations and anything else professionally relevant.
- The clinician may obtain or refer to previous medical records for relevant patient history or diagnoses, previous testing, or may compare current test results to previous results.
- The clinician considers a differential diagnosis, acknowledging all possible diagnoses which could explain the given medical data.
- The clinician eliminates certain differential diagnosis possibilities, settling on a diagnosis or concluding further investigation is needed to rule out multiple possibilities.
- Instructions for each diagnosis or possible diagnosis in order to provide the best possible care given the patient’s condition and relevant medical history.
- The clinician may discuss a case with a patient’s primary care physician or consultants.
The MDM process uses a number of skills clinicians acquire through every day practice and training in order to make an informed decision to produce the optimal outcome for a patient. Medical billing often uses MDM to justify the use of certain coding levels.
What does MSO mean in project management?
Tackling population health with a new management engine. – As risk continues to shift from health plans to providers as part of managed care value-based contracting arrangements, many of the functions and services traditionally owned by health plans are now more appropriately owned and operated by health systems, IPAs and ACOs.
- A management services organization (MSO) can be a gateway for providers to apply a population health lens to their practice or network with a focus on quality and outcomes, ultimately enabling the practice to better control overall the total cost of care.
- MSOs, administrative services organizations (ASOs), care management organizations (CMOs), population health services organizations (PHSOs) and the functions they provide, come in many shapes and sizes.
The governance structure and functionality of an MSO is unique to the health system, IPA, ACO or health plan it is designed to serve. A provider taking risk can design or outsource an MSO for a single function/service or many functions/services depending on their needs.
- Many health systems are balancing the MSO type needs of a wholly owned or joint venture health plan, one or more ACOs and one or more IPAs.
- As a result, health systems and provider organizations are grappling with decisions about which functions they can realistically provide and how they can organize themselves to deliver these functions in a cost-effective way that allows them to capture and effectively manage as much of the premium dollar as possible.
COPE Health Solutions works in collaboration with our clients to help them understand the value of MSO infrastructure as they consider opportunities to manage risk, improve financial and clinical performance and meet the needs of all members. Our team helps clients to understand the scope of MSO service and capabilities, assess existing MSO services and capabilities and recommend solutions to optimize performance, align with market drivers, and achieve both short and long-term member management goals.
Leverage a standard, yet customizable evaluation tool to enable benchmarking of MSO services, pricing and capabilities against industry leading MSOs Conduct a comprehensive, detailed analysis to assess organization’s market need, existing infrastructure (including IT), re-deployable resources, current vendor contracts and organizational readiness Provide actionable recommendations and strategic planning to help your organization prioritize investments in MSO services and capabilities, including build/buy decisions Develop operational plan and implementation support for any recommended initiatives or procurement processes necessary to optimize MSO services and capabilities
: Managed Services Organization (MSO) Development and Optimization
What is the difference between DSO and MSO?
The Mixed Signal Oscilloscope – An MSO provides all the functionality of the DSO but adds in a connector port to the front panel that allows you to connect a logic probe to your scope. The logic probe provides 16 separate digital channels as well as the full functionality of a digital storage oscilloscope and sounds too good to be true, but I promise you it isn’t.
- It’s just quite a bit more cash to fork out to be able to view your digital channels alongside your analog channels.
- What do we mean by alongside? Well on one screen you are able to view 16 digital channels and 4 analog channels on the same time domain.
- It’s invaluable if that’s what you need to do.
- It can also get a little hectic, cramming all those signals onto the one 7 inch display.The DSOs functions were made relatively clear in that article, however, you don’t get the ability to attach digital channels to your scope and look at them with time correlation to your Analog channels.
If that was your requirement; The Mixed Signal Oscilloscope is the unit you’d find yourself looking at.
What is MSO style?
Last Updated: 1 st March 2023 If you’ve been working in email dev, you may have come across mso- prefixed styles in the code, I mention them a few time on this site. MSO styles are styles that are specific to MSO ( M icro S oft O ffice), some of these styles are unique to MSO but often these are repeats of standard CSS styles, in which case they can be used to provide a different value in MSO email clients.
The MSO email clients include Outlook desktop app on Windows, and Windows Mail the rendering of these apps is based on Microsoft Word. Other versions of Outlook, such as the Mac app, Android app, iOS app, the webmail and Progressive Web Apps (PWA) use regular HTML rendering and don’t support these MSO styles.
There are a lot of MSO prefixed styles as documented in this great resource, Stig’s MSO reference page, Stig got this recourse from Jason who shared a Microsoft Office HTML and XML Reference PDF that he in turn downloaded and decoded from this Microsoft® Office HTML and XML Reference,
- MSO text styling
- MSO advanced text styling (Word Art)
- MSO box model
- MSO backgrounds
- MSO table styles
- MSO List styles
- MSO element
- more to follow
What is MSO in project management?