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MSO Service

Recruiting and HR for healthcare practices

Clinician recruiting, compensation design, onboarding, and the employment compliance most practices only think about after something goes wrong.

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CPA-led · Nationwide & fully remote · Flat monthly fees
A practice team reviewing performance charts together around a table

Works with the tools you already use

GustoADPOffer modelingClassification reviewHandbook & policy
The Problem

Your largest expense and your largest exposure are the same line item

People are sixty to seventy percent of practice cost and the source of nearly every compliance problem that reaches a lawyer. Most practices manage both with a template offer letter.

Recruiting without a comp model

You cannot make a competitive offer if you do not know what the role can afford. We model the position before you post it, so the offer is both attractive and survivable.

Classification exposure

W-2 or 1099 for clinicians is the most expensive question in healthcare employment. Under standards like California ABC test, getting it wrong is a back-taxes and penalties event.

Onboarding that leaks

Payroll setup, benefits enrollment, credentialing, and policy acknowledgment fall through the cracks when nobody owns them. We own them.

What You Get

Everything your practice needs behind the front desk

One integrated, CPA-led team handles the entire business side, so your energy stays on care.

Explore all services →
  • ✓ Clinician and admin role recruiting support
  • ✓ Compensation modeling before the offer goes out
  • ✓ W-2 versus 1099 classification review, documented
  • ✓ Offer letters and employment agreement templates
  • ✓ Onboarding and payroll setup end to end
  • ✓ Employee handbook and policy documentation
  • ✓ Benefits and retirement plan coordination
  • ✓ Ongoing employment compliance support
What You Get

What recruiting and HR includes

The people function of a practice, run by the same team that runs the numbers, so compensation decisions and financial reality stay connected.

01

Assess

A free deep-dive into your books, entity, comp, and pain points.

02

Build

We clean up the books, set your chart of accounts, and stand up the compliance calendar.

03

Run

Monthly financials, payroll, and tax filings delivered like clockwork.

04

Grow

Quarterly strategy, benchmarking, and proactive tax planning.

A worked example

What a classification decision costs

The 1099 that looks cheaper is usually the most expensive thing in the practice.

W-2 versus 1099 for a treating clinicianIllustrative
Contractor rate, annualised$118,000
Employee equivalent: salary$104,000
Employer payroll taxes at roughly 9%$9,360
Benefits, workers’ comp and admin$11,800
True employee cost$125,160
Apparent saving from 1099$7,160
Exposure if reclassified: back taxes, penalties, interest$38,000–$62,000
Plus unpaid overtime and meal-break claims, CaliforniaUncapped

What this tells you

  • Why the saving is not realThe comparison most owners run stops at the rate. It leaves out the risk-weighted cost of being wrong, which in California is the dominant term.
  • The test that actually appliesCalifornia applies the ABC test. A clinician delivering the service the practice sells rarely satisfies prong B. That is the prong that decides most cases.
  • What we doReview each role against the test, document the basis, and where reclassification is needed, sequence it so the correction does not create a bigger problem.

Illustrative ranges to show the shape of the exposure, not a legal opinion or a quote. Classification is fact-specific and we work it alongside your employment counsel.

Questions

How the people side gets handled

No. We do not charge placement fees on salary. We support the hiring process, model what the role costs and earns, and handle the compliance and onboarding around it.
Sometimes, and less often than practices assume. Under the California ABC test in particular, a clinician doing the core work of your practice is usually an employee. We document the position properly rather than choosing the convenient answer.
Yes, full-service payroll, 1099 filings, and the quarterly and annual returns, integrated with the accounting so labour cost reporting is accurate without extra work.
The Difference

No equity. No percentage of your growth.

Most management services organizations charge for your back office by taking ownership or a share of every dollar you collect. One costs you control. The other costs you more each year you succeed.

Equity MSOs take ownership

A DSO or private-equity group provides the back office in exchange for a stake. You get infrastructure. You also get a board, a budget you no longer set, and an exit on their timeline.

Percentage MSOs tax your growth

A fee set as a share of collections does not stay flat. Running your back office is not twice the work when revenue doubles, but the fee is. Every good year costs you more.

We take neither

A flat monthly fee for a defined scope. No equity, no share of collections, no right of first refusal if you sell. Grow the practice and the upside stays with you.

Why our model is different →

Get Started

Ready to make hiring a financial decision?

Book a free assessment. We will review your comp structure, classification exposure, and what your next hire actually needs to produce.

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