MS Centers: Their Voyage to the New World of Health Care

Background: Comprehensive Multiple Sclerosis Centers are challenged in an era of uncertain health care reform.

Objectives: to examine the structure, mission formation, operations and business and financing structures available to MS Centers

Methods: to review experience with the founding, staffing, operations and mission fulfillment of other centers dealing with the comprehensive, longitudinal care of chronic illness and to examine particularly the operations of MS Centers within both free-standing settings and within complex institutions

Results: MS Centers will be compared to others dealing with biomedical research, deforming trauma, and leprosy on an international level

Conclusions: MS Centers are presented with both the opportunity and the necessity to examine their approaches to care delivery, technology, mission stability, organizational stability, governance, operational relationships and funding if they are to survive the tumult of the current health care era everywhere and be able to serve those under their care.

Abstract Text:

MS Centers in general provide comprehensive care to persons with MS. Their organizations a multidisciplinary and most are located with the walls of academic parent institutions while others are independent. Patient care is the central mission of most (but not all), and ancillary roles of research and education are featured. Care is generally and ultimately delivered on a fee-for-service basis paid by a variety of private or public insurance sources.  Their governance is pyramidal (a Renaissance Model) and compelled by business considerations.  Given the changing nature of health care structure and financing, prominent in the USA but present everywhere, it is imperative that MS Centers anticipate and act upon the structure and operational governance that will allow them to organize and grow their operations in the future. Among those features which require studied consideration are these: Mission Re-enforcement and Modification; Modification of Organizational Structure and Governance; Demonstration of Real World Outcomes; Anticipation of Changes in Funding; Re-Evaluation of Relationships with Essential Partners, including Corporations and Academia; the Inculcation of New Technologies; Involvement of Patient and Community Groups; and Common Core Accreditation.  Address of these issues is not exclusive to MS Centers, but is drawn from experience with other centers devoted to long-term, comprehensive care throughout the world.