Management Service Organizations 

DPT Healthcare Partners oversees the management and revenue development of ancillary services for both physicians and billing ancillary service providers. Our focus is compliance (both legal and patient), to deliver efficiencies and outcomes that create a better continuity of care, and a greater profit margin. These efforts are combined with third party validation of provable outcomes (MACRA/MIPS) as required by CMS.


Whenever possible we provide and/or manage services within the physician’s practice. When this is not practical or appropriate, we enlist the physicians as partners in our Management Service Organizations (MSOs). Clearly the physician MUST be in this proactive loop if there is going to be collaborative success. Any revenue from administrative services discussed in our introduction also are in the MSO. 


What is an MSO and how are they legal?

For 30+ years, every surgery center, and most imaging centers have had management companies (MSOs) owned by physicians. Even hospitals have their version of this simple structure called a “Co-Management Agreement”. Our program is exactly the same and compliance is simple. Please see the attached page from the website, starklaw.org.


The significant difference between what we do and a typical MSO, is that our MSOs have no contractual relationship with any billing provider. Strategic partners around the country, who hold national management contracts with ancillary service providers, bring us in because of our expertise over several verticals (lab, pharmacy, imaging, PT, DME, etc.), our national network of field support reps, and our ability to produce objective provable outcomes including MACRA/MIPS. We are merely management subcontractors to those management groups with no relationship with any billing provider.


Physician Entrepreneurs – Participate in revenue development programs within their offices, or incorporating outside services that their practice regularly utilizes such as lab, pharmacy, PT, DME, imaging, etc. The small investment safe harbor requires a small investment, commensurate with expected return, to be made to compliantly earn revenue from some of these remote programs. Investment requirements range from a start of $1,000, extending to $20,000, with the vast majority falling between the $2,500 (single office) - $5,000 (multi-office).

Physician Investors – Earn 16-20% annually (interest paid quarterly) on deposits placed with DPT Financial Services. This is a two year note with the option to convert to equity in a public company at the end, or simply take the return of principal. Because two private and two public companies have already approached DPT about acquisition, this could be especially valuable.


Though our physicians are not in any way compensated based on their production, the companies who contract us earn significant management fees that they share with us for servicing their accounts with our national network. Please see the attached spreadsheet for an example of the dollars that are presently lost to most physicians.

Medical Space/Medical Equipment Leasing Companies; Management Companies

Medical space/medical equipment leasing companies and medical management companies continue to present investment opportunities for physicians. Typically, a leasing company will either own or lease space and/or equipment and will lease, or sublease, the space and/or equipment to a health care facility. In return for the lease or sublease of the space and/or the equipment, the health care facility will pay the leasing company a rental fee. A management company will manage a health care facility by performing tasks such as billing, collecting, accounting, hiring and firing of personnel on behalf of the health care facility. In exchange for its performance of management functions, the health care facility will pay the management company a management fee.


There are no restrictions on the physician specialty that can invest in a medical space/medical equipment leasing company or in a medical management company. As noted earlier, under the ASC Safe Harbor, physicians who want to invest in an ASC must be in a


position to refer patients directly to the ASC and perform surgery on such referred patients. It follows that primary care physicians are not permitted to invest in ASCs. However, even though a primary care physician cannot invest in an ASC, he can invest in (1) a medical space leasing company that owns or leases the building in which the ASC is located and that leases or subleases the space to the ASC; (2) a medical equipment leasing company that owns or leases equipment, such as MRIs and CTs, to the ASC and (3) a medical management company that manages the ASC.


Investments in medical space/medical equipment leasing companies and medical management companies should be structured to fall within the Small Investment Safe Harbor. The Small Investment Safe Harbor requires, in part, that no more than 40 percent of the investment interests be held by investors who are in a position to make a referral for the entity and no more than 40 percent of the entity’s gross revenue may come from referrals or business otherwise generated from investors.


Furthermore, lease agreements between the leasing companies and the health care facilities and the management agreements between the management companies and the health care facilities must be structured to fall within other applicable Safe Harbors and the exceptions to the Stark Law. The applicable Safe Harbors for leases and management agreements and the applicable Stark Law exception for leases require, in part, that the rent under the leases and the management fee under the management agreement be at the fair market value and not be determined in any manner that takes into account the volume of patients referred to a health care facility by a physician owner of the leasing company or the management company.

DPT HEALTHCARE MANAGEMENT (DPT HCM) MSO FLOW CHART

DPT is presently made up of six separate management companies – only one offers MSOs.

MANAGEMENT & REVENUE PROGRAM OPTIONS

LABORATORY        PHARMACY        PHYSICAL THERAPY        DURABLE MEDICAL        EQUIPMENT

ALLERGY TESTING        BILLING & COLLECTIONS        ACCOUNTING –        PAYROLL SUPPLIES

INSURANCE SERVICES (Health/Workers Comp/Malpractice)        UNIFORMS        CCM        ETC


1. Lab (or other ancillary service billing provider) contracts third party management companies to provide national management services at Fair Market Value (FMV) for the lab in its entirety. These management companies are Strategic Partners of DPT HCM.


2. These Strategic Partners contract DPT HCM to provide some of the more burdensome management tasks because we have a long history of expertise in many ancillary service areas, have a national network of field service reps, and provide 3rd party validation of provable outcomes via value based care metrics, including MACRA/MIPS.


3. The field support and service aspects are provided by our MSOs.


4. In addition, the MSOs can provide practice administrative and support services such as,

billing/collections, insurance (health, workers comp, malpractice), payroll, accounting, equipment, uniforms, supplies, etc.


5. Neither DPT HCM, nor any MSO has any contract with any lab or other billing ancillary service provider. The MSO serves only as a field support management subcontractor for DPT HCM.


6. DPT HCM is compensated based on a combination of work and expense units for work performed nationally across many ancillary service verticals, including lab, pharmacy, imaging, PT, DME, etc.


7. DPT HCM pays MSO partners based on the region’s proportionate number of work and expense units.


8. A work unit has no present financial value. It is very current, and therefore may not yet have even been billed, and certainly has not been collected. A work unit could result in no payment, a $4,000 reimbursement for blood allergy, or a $75 physical therapy visit. All work units are treated equally and without financial value.


9. Our Strategic Partners are not compensated based on production and neither is DPT HCM.

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