Physician practices have been struggling against a rising tide of consolidation efforts by a range of corporate entities, including hospitals, health systems, private equity and insurance companies.
In response to this trend, a new wave of management services organizations and similar physician-led platforms have emerged in the physician practice space with the goal of keeping practices independent while providing them with the resources of a corporation or health system.
David Eagle, MD, president of the American Independent Medical Practice Association, told Becker’s that MSO platforms can be a saving grace for struggling physician practices.
“The MSOs are kind of the new avenue and it is by far the best way for practices to preserve their autonomy and independence compared to the other two choices,” he said, referring to a corporate entity or a hospital.
“I think it’s really important for that MSO pathway to be open for practices,” he added. “Otherwise, it just means more hospital consolidation. And we’ve had enough of that already.”
In 2024, at least 47% of physicians were employed by or affiliated with hospital systems, an increase from about 30% in 2012, according to a new report from the Government Accountability Office. Meanwhile, just 42% of physicians worked in private practice in 2024, down from 60% in 2012.
These platforms offer a variety of ownership models and access to resources, with some tailored to the needs within a specialty. Dr. Eagle, an oncologist, practices in a large oncology group with locations throughout New York, all of which are a part of OneOncology, a physician-led MSO that provides independent practices with shared infrastructure, data analytics, operational support and growth resources.
East Patchogue-based New York Cancer and Blood, where Dr. Eagle practices, was one of the founding practices within OneOncology’s network, and he has witnessed firsthand the MSOs’ ability to support independent practice growth in a sustainable way.
“People have been scrutinizing the MSO model, but it allows us to do so many things,” he said. “We can expand our clinical trial offerings, we can improve practice operations. We can give them the data they need to improve their operations and coaching on how to negotiate with payers.”
OneOncology also helped his practice create a precision medicine program, a huge benefit in a field like oncology where genetic factors often play a role in the diagnosis. Being able to concentrate resources into a program with staff pathologists, tumor boards and other resources is a significant, bespoke benefit for patients.
Another key benefit his MSO offers is an ongoing project to create a pool of generic drugs to combat often unpredictable drug shortages.
“What we can offer to practices as a part of the MSO model is that they can buy into a reserve of six months’ supply of generic drugs,” he said. “So if a shortage happens again, the practices will have access to the drugs.”
MSOs can be highly nimble in this way, responding to clinical concerns and near-constant shifts and demands in healthcare with immediacy.
“That’s just another innovative example of how an MSO can solve a problem that, frankly, Congress hasn’t solved in over 10 years,” Dr. Eagle said. “Even though they’ve been paying attention to that.”
