Structures That Align Control, Compliance, and Incentives
We architect, update, and scale MSO/DSO/VSO models that work in practice and withstand scrutiny. Our structures balance operational control with regulatory compliance while creating alignment between management companies and clinical entities.
Entity Design
Service organization / professional entity architecture (MSO-PC structure), governance structures, and holding company models
MSA Agreements
Management services agreements, fee structures, and ancillary arrangements
Provider Alignment
Equity participation, profits interests, and compensation frameworks
Expansion Playbooks
Multi-state documentation and scalable platform models
Core Work
- Entity architecture: MSO/PC structures, holding company design, governance frameworks, board composition, and committee charters that balance control with compliance
- Operating agreements: Operating agreements, board composition, and company charter documentation for platform and clinical entities
- Management agreements: Comprehensive MSAs covering administrative services, fee calculations, space and equipment, HR and staffing, supply chain, and IT infrastructure
- Provider alignment: Equity participation models, profits interest structures, production-based compensation, quality metrics, and performance frameworks for physicians, dentists, and veterinarians
- Regulatory navigation: Fee-splitting analysis, anti-kickback considerations, corporate practice compliance, and documented positions for each state of operation
- Expansion infrastructure: State-specific documentation, new market playbooks, and template libraries that accelerate growth while maintaining compliance consistency
Outcomes
- Consistent documentation: Standardized agreements across all locations that reduce legal complexity and accelerate add-on integrations
- Aligned economics: Fee structures and compensation models that incentivize performance while respecting regulatory boundaries
- Diligence readiness: Clean corporate structures and documented compliance positions that withstand buyer scrutiny
- Scalable platform: Repeatable models that support rapid growth without recreating the wheel for each new state or acquisition
Structures Team
Our team combines corporate, regulatory, and tax expertise to design structures that work operationally, legally, and economically.
Why Structure Design Matters for Healthcare Platforms
The MSO/DSO/VSO model is the foundation of modern healthcare platform economics. Get it wrong, and you face corporate practice violations, fee-splitting problems, or misaligned incentives that drive away your best providers. Get it right, and you create a scalable engine for growth that aligns management and clinical interests while maintaining regulatory defensibility. We've designed structures for platforms from initial formation through billion-dollar exits, and we bring that experience to every engagement.
Ready to Optimize Your Platform Structure?
Our team is ready to help you design or refine structures that support your growth objectives.
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