More than 100 million U.S. adults are now living with diabetes or prediabetes, according to the Centers for Disease Control and Prevention.1 This epidemic requires new healthcare models to deliver optimal, patient-focused, guideline-directed care to improve outcomes and reduce costs. The establishment of a new multispecialty Managed Services Organization (MSO) in Arizona spotlights the numerous benefits, to patients and providers alike, of providing end-to-end healthcare services and disease management solutions for complex diabetes.
The new MSO has been established in Arizona using a partnership model that includes a pharmaceutical company, a major endocrinology center, and a large primary care practice that collectively care for a patient population of about 65,000, of whom approximately 25,000 are insulin-dependent diabetes patients. Under this patient-centered MSO model, patients receive diagnostic checkups and guideline-directed preventative care, all under one roof, in a collaborative environment focused on diabetes control and patient health. Provider services include endocrinology and primary care offerings as well as ophthalmology, podiatry, and neurology clinics, together with an associated, in-house pharmacy and laboratory. By focusing on the maintenance of patient health, this MSO is built to reduce the need for expensive “sick care” and hospitalization thereby positioning the group for risk sharing and outcomes-based payment models that are expected to drive healthcare reimbursements into the future.
While there are numerous examples of multi-specialty physician practices partnering for disease management, the exceptional element of this combined entity is the inclusion of a pharmaceutical and medical device manufacturer in the partnership. The pharmaceutical company operates as a holding company with subsidiaries that discover, design, develop, manufacture, and deliver drugs, biologics and devices that can be utilized by the MSO physicians to the benefit of their patients.
These include a clinically proven cellular tissue product (C/TP) that is FDA cleared for the management of 17 types of wounds including diabetic foot ulcers and venous stasis ulcers that are prevalent in the diabetes population. A range of surgical and biologic products used in diabetic foot and ankle surgery and biologic tissue from umbilical cords used for tissue regeneration are offered.
By integrating products and services from discovery through development and clinical application, the new MSO model provides end-to-end solutions that optimize care delivery, reduce costs through manufacturer’s direct to physician pricing, and improve practice margins by eliminating middlemen from the supply chain. Patients benefit from the reduced costs and they gain access to new, state-of-the-art products for diabetes management.
Additionally, patients and MSO physicians also have the opportunity to participate in clinical research trials as the MSO is building the Arizona Center for Diabetes Research. Therapies in development include implantation of microencapsulated stem cells and Sertoli cells utilizing patented and proprietary technologies for the treatment of type 1 diabetes, as well as a buccal insulin spray for type II diabetes.
A multispecialty MSO Allows Doctors to Focus More on Delivering Care
Doctors in this Arizona MSO model gain control over their practices and maintain independence by expanding their revenue opportunities through the provision of ancillary services like laboratory and pharmacy and through establishing collaborative and comprehensive specialty care services for diabetes patients. Furthermore, because the model incorporates the manufacturer and distributor of treatments and services, physicians can purchase direct to eliminate middlemen and improve practice profitability, while preserving the classic doctor-patient relationship. Unlike the traditional fee-for-service model, where quantity of care is prioritized over quality, the new model allows the focus to remain on healing patients.
Augmenting the practices, the MSO incorporates IT systems and a common electronic health record to handle collaborative data sharing, data analytics and chronic care management programs, including a telemedicine platform for interacting with remote patients, ensuring compliance with medication regimens and care plans.
By bringing integrated and collaborative care to patients, this multi-specialty MSO model not only enhances wellbeing but also allows physicians to grow their practices and achieve greater profitability without compromises.
- A well-designed MSO model can reunify doctor-patient relationships that have been impacted by large healthcare systems and giant insurance conglomerates.
- Integrated collaborative care can ensure not only better health outcomes for patients but also provide partnerships that add value for healthcare practitioners.
- Incorporating end-to-end solutions into the MSO model—from discovery to development to distribution—is a win-win for all stakeholders.
- Centers for Disease Control and Prevention. “New CDC report: More than 100 million Americans have diabetes or prediabetes.” Available at: https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html
Richard Purcell is Executive Vice President of Research & Drug Development at Generex Biotechnology, an integrated healthcare company with end-to-end solutions for patient centric care from rapid diagnosis through delivery of personalized therapies. Generex announced plans in September of this year to establish the NuGenerex Diabetes Research Center in collaboration with Arizona Endocrinology Group and Paradise Valley Family Medicine.