How Intentionate Healthcare Advisors Helped a Physician-Owned Network of Specialty Clinics Position Itself for Expansion and Outside Investment

Our Client

Two entrepreneurial physician-owners founded and rapidly grew a network of specialty clinics across four states. They needed a strategic framework to support their vision for continued expansion and prepare the business for potential outside investors.

With those goals in mind, the owners restructured the company into separate legal entities:

  • State-level professional corporations (PCs) to employ or contract with physicians
  • A management services organization (MSO) to provide nonmedical personnel, space, equipment, supplies, and services for the clinics—in exchange for a management fee paid by the PCs

To support this arrangement, the client needed to identify an MSO management fee structure that would:

  • Ensure that management fees aligned with fair market value and commercial reasonableness principles
  • Comply with applicable laws and regulations (e.g., the Stark Law, the Anti-Kickback Statute, corporate practice of medicine restrictions)
  • Position the practice to appeal to potential investors in the future

Our Approach 

On its attorney’s recommendation, the client engaged Intentionate Healthcare Advisors. Intentionate helps clients achieve success with practical, step-by-step strategies tailored to their specific situation and goals. For this client, we:

  • Analyzed each clinic’s financial operations down to the line-item level
  • Offered guidance on allocating staff and other resources to management company and operational units at the state, regional, and clinic levels—including advising on reasonable allocation of time and effort for staff in various roles
  • Reviewed hundreds of financial statements for companies in related sectors to establish market rates for management services
  • Recommended an MSO management fee structure aligned to the client’s unique goals
  • Helped the client anticipate and avoid potential operational trouble spots
  • Supported the client during implementation, so they could smoothly transition to the new business model

Our Results

With Intentionate’s guidance, the client established a new MSO framework that provides a vehicle for strategic, consistent expansion—including de novo clinics and acquisitions of existing practices—and is more appealing to potential investors.

The physician-owners said Intentionate’s expertise and thoughtful approach “brought confidence to the process,” freeing them to focus on their entrepreneurial vision.

The client’s attorney, who worked closely with Intentionate on the project, said that Intentionate Principal Stu Schaff “is incredibly knowledgeable about MSO structures and expertly guided the client through the process. The client appreciated his proactive approach, communication style, exceptional project management, and level of service. I highly recommend Intentionate and will continue to work with them in the future.”

About Intentionate Healthcare Advisors

Intentionate Healthcare Advisors is a trusted partner to physicians, hospitals, health systems, and other healthcare providers throughout the United States. Led by founder Stu Schaff, Intentionate advises clients on the business of medical practice, with a focus on physician compensation, physician-hospital alignment and transactions, and financial performance improvement. Intentionate’s consultants have successfully handled hundreds of complex matters, applying their experience and expertise to help clients achieve their unique goals.

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