Best Med Spa MSOs (2026): 10 Management Services Organizations Compared
What is an MSO? How the med spa MSO and friendly PC model works, plus 10 MSOs and platforms compared, incl. MedGrid MSO, Upkeep Ventures and Aviva.
For med spa owners, nurse and injector founders, and investors. Updated October 22, 2026 · Prepared by Prospyr. Prospyr makes practice software, not management services, and none of the companies below is a Prospyr product or partner. This guide explains what a med spa MSO is and compares 10 MSOs and platforms that partner with med spa owners. Each summary reflects what the company publishes on its own website, checked October 2026. This is not legal, tax or financial advice. Ownership rules differ by state and change often, so have your own healthcare attorney review any structure or agreement before you sign.
What is an MSO?
An MSO, or management services organization, is a company that runs the non-clinical side of a medical practice, such as hiring, payroll, billing support, marketing, purchasing, leases and reporting, under a written management services agreement, while licensed providers keep control of patient care. In healthcare, MSOs are used by physician groups, dental groups, private equity platforms and med spas. For a med spa, the MSO is usually the business that owns the brand, the lease and the equipment, and it charges the medical practice a management fee for its services.
How the med spa MSO and friendly PC structure works
Many states have corporate practice of medicine (CPOM) rules that limit who can own a medical practice or employ the providers who treat patients. In those states, a non-physician founder, such as a nurse practitioner, registered nurse, aesthetician or investor, often cannot own the medical spa outright. The common workaround is a two-company setup:
- The medical practice (often called the PC or "friendly PC"). A professional corporation or professional LLC owned by a licensed physician, or in some states another licensed professional. It holds the clinical side: medical director oversight, treatment protocols, good faith exams, delegation, charts and the providers who treat patients.
- The MSO. A regular company that a non-physician can own. It provides the space, team support, marketing, purchasing, accounting and technology to the practice under a management services agreement, and earns a fee for those services.
The word "friendly" refers to a physician owner who works closely with the MSO's owner. The details that matter, such as how the management fee is set, who can hire and fire providers, who controls patient records and what happens if the physician leaves, are legal questions with state-specific answers. Some states have tightened oversight of MSO arrangements; our post on California's new PE and MSO law is one example. Confirm your state's rules with a healthcare attorney before you form anything. Our healthcare attorneys for med spa ownership list compares 10 firms, and our PC, PLLC and MSO comparison explains the entity types.
Three kinds of med spa MSO partner
- Build-your-own MSO services. The company helps you form your own MSO and PC, finds a physician and keeps the compliance file current. You own the business. Examples below: MedGrid MSO and Obsidian Med Spa Consulting.
- Operating partners that leave ownership with you. The company runs operations, purchasing or back office for a fee or a share of growth, without buying your practice. Examples: Upkeep Ventures, myMedSpa and Aviva Aesthetics.
- Platforms that take a stake. Investor-backed groups that buy all or part of your practice and run its business side from a central team, which is how many of them operate as an MSO. Examples: Empower Aesthetics, PAVA USA, Advanced Medaesthetic Partners, MedSpa Partners and Spa Medicca. Our private equity platforms guide covers these in more depth.
The 10 med spa MSOs and platforms at a glance
| # | Company | Model | Published pricing or terms | Worth a call if you want |
|---|---|---|---|---|
| 1 | MedGrid MSO | Medical direction, friendly-PC compliance and supply membership | Onboarding and monthly fee quoted per clinic; 12-month term | Your own MSO and PC set up with a physician in your state |
| 2 | Obsidian Med Spa Consulting | MSO and PC formation plus back office for NP and RN founders | Flat fee advertised; amount not published | Entity filings, contracts and bookkeeping for one fee |
| 3 | Strategy Aesthetics (Upkeep Ventures) | Operating partner for owners who want to step back | 0% equity; no flat fees or retainers; paid on growth | Daily operations handled while you keep ownership |
| 4 | myMedSpa | Hands-on operating and investment partner | Not published; custom deal per practice | An operator team that has run med spas itself |
| 5 | Aviva Aesthetics | Owner-governed platform | Owners keep 100% of their equity until a future platform sale | Group support now and a group exit later |
| 6 | Empower Aesthetics | Investor-backed platform with central back office | Not published | Back office, marketing and new-location help from a group |
| 7 | PAVA USA | Clinician alliance with shared operations | Not published | A clinician-led group that keeps your brand and clinical leadership |
| 8 | Advanced Medaesthetic Partners (AMP) | Platform with three partnership tiers | Tiers range from operational support to a joint venture; prices not published | A choice of how much ownership to give up |
| 9 | MedSpa Partners (MSP) | Acquirer with a full central services team | Not published | A full sale with most business functions handed off |
| 10 | Spa Medicca | Growth partner or full exit | Customized structures; not published | A partner that runs HR, compliance, inventory and billing centrally |
How we chose this list
We looked for companies that name med spas or aesthetic practices as their market and offer to run or support the business side, then checked four things an owner can verify before a first call:
- What the company actually runs: structure and compliance only, back office, daily operations, or everything.
- How it is paid: a flat fee, a monthly fee, a share of growth, or equity in your practice.
- What you keep: ownership, brand, clinical leadership and the right to leave.
- How plainly it explains its terms on its own website.
We left out companies whose offer includes their own practice software, booking or EMR, because they compete with Prospyr, and law firms, which we list separately. Medical director placement firms such as Medical Director Co. support MSO-based med spas but are not MSOs themselves; see our medical director services list. Back-office staffing firms are also left out. The order is our editorial view, not a measure of results.
1MedGrid MSO#
MedGrid MSO combines physician medical direction, compliance documents and a wholesale supply catalog in one membership for med spas, IV, weight-loss and other wellness clinics. It is built by Skydell Holdings, a medical supply company.
What stands out:
- Friendly-PC structure, spelled out. It lists a management agreement, delegation and standing orders, consents and a clearance screening policy, drafted for your state.
- A physician in your state. It matches you with a physician licensed in your state, paid a flat monthly stipend set by state and scope.
- Speed. It advertises going from signing to seeing patients in about 30 days.
- Back office. Entity formation, EIN, banking, payroll, insurance and vendor onboarding, with accounting and marketing listed as other services.
- Terms. Its pricing page says onboarding and the monthly fee are quoted per clinic before any paperwork, with a 12-month term. Its homepage states membership carries no equity, purchase option or non-compete. Catalog access is free for verified clinicians.
Right for: a nurse practitioner, injector or entrepreneur opening a first clinic who needs the structure and the compliance file more than an operator. Ask: who drafts and owns the MSO and PC agreements, what happens at the end of the 12-month term, and whether you can buy supplies elsewhere.
2Obsidian Med Spa Consulting#
Obsidian Med Spa Consulting works with nurse entrepreneurs (NPs and RNs) launching their own med spas. It advertises a flat, fixed fee instead of the 15 to 20% revenue share some management models charge, though the fee itself is not published.
What stands out:
- Your own entities. It lists MSO and PC entity filings and a custom contract packet reviewed by a healthcare attorney.
- Back office. Ongoing bookkeeping, KPI dashboards, compliance reminders and monthly advisory hours.
- Launch marketing. A one- to five-page website, basic SEO and a launch playbook.
Its bundle also includes a pre-configured EMR, booking and POS system from a third-party vendor. If you would rather choose your own practice software, ask whether the fee changes.
Right for: an NP or RN who wants to own the MSO outright and have the legal and accounting setup handled for one predictable fee. Ask: the fee and term, which states its attorneys cover, who the physician owner of the PC will be, and what happens to your entities and contracts if you leave.
Choosing vendors for your practice?
Prospyr runs the practice they plug into: booking, charting, packages and payments on one patient record. We move your data over for you.
3Strategy Aesthetics (Upkeep Ventures)#
Upkeep Ventures offers to take over day-to-day operations of an existing med spa while the owner keeps the business. It is led by Shane Smith, who the site says founded UPKEEP Med Spa and is CEO of Alchemy 43, and it reports 16+ locations under management across those two brands.
What stands out:
- No equity, no flat fee. It states that it never takes ownership of your business and charges no flat fees or retainers; its pay is tied to growth above your existing baseline.
- Operations plus purchasing. Operations management, capital raising, and group purchasing of injectables, equipment, supplies, marketing and technology, with a custom management plan.
- Brand stays yours. It states it does not rebrand partner practices.
Right for: an owner who is burned out on operations and wants to step back without selling. Ask: exactly how the baseline and growth share are calculated, how long the agreement runs, and how many outside practices it manages today beyond its own two brands.
4myMedSpa#
myMedSpa partners with growth-stage med spa owners on operations, staff development, systems, inventory, vendor negotiations, site selection and multi-location expansion. Founded by CEO Jerred Mann, it describes its team as former med spa owners, providers and healthcare professionals, and calls itself "smaller by design." Its wording ("we don't just invest") suggests some partnerships include investment, but it does not publish deal structure or fees.
Right for: a multi-location or growth-stage owner who wants an operator team working inside the practice, not remote consulting. Ask: whether the deal includes equity, how the management fee is set, and what happens to your brand and team if you part ways.
5Aviva Aesthetics#
Aviva Aesthetics is a Chicago-based med spa platform and a DuneGlass Capital company. Under what it calls its Entrepreneur Equity model, owners keep 100% of the equity in their business and their profits while the group prepares for a collective future sale to private equity.
What stands out:
- Owner-led governance. It reports an owner-majority board and owners chairing all of the platform's management committees.
- Platform support. Business and financial support from a central team, plus the Aviva Academy of webinars and guides.
- A growing footprint. Its news feed announces partner practices in states including Texas, Arizona, Illinois, Ohio, Georgia, New Mexico and Oregon.
Aviva advertises that owners can earn 2 to 3 times more at a platform sale than in other exits. That is the company's own projection, not a guarantee.
Right for: an established owner who wants group support and buying power now without selling a stake today. Ask: what fees you pay before the platform sale, how and when that sale is decided, and what happens if it doesn't happen.
6Empower Aesthetics#
Empower Aesthetics describes itself as a medical aesthetics platform that partners with med spa and aesthetic entrepreneurs to help them grow. Its site lists 12 partners and 20 locations, and 25+ sister companies in healthcare. Its footer names SCP Medspa Services, LLC.
What stands out:
- A central back office. Payroll, bill pay and other back-office support.
- Growth functions. A multi-channel marketing engine, new location development and ramp-up, group purchasing and provider utilization, and analytics.
- People. Talent recruiting, training and retention.
Its homepage does not describe deal structure, equity or brand terms.
Right for: an owner who wants to add locations with a group's marketing and development team behind them. Ask: whether partnering means a sale, what share you keep, who backs the platform, and whether your practice name stays.
7PAVA USA#
PAVA USA (Premier Aesthetics & Vitality Alliance) describes itself as an alliance of entrepreneurial clinicians that partners with established aesthetics practice owners to strengthen operations and performance. Its leadership page lists physician executives, including CEO Dr. Douglas Wisor. It lists 13 partner practices across Oklahoma, Arkansas, Maryland, Virginia, Missouri and Washington, DC.
What stands out:
- Brand and clinical leadership stay. It states each practice keeps its own brand, culture and clinical leadership, and clinicians keep clinical autonomy.
- Shared services. Recruiting and training, IT, digital marketing and SEO, patient engagement, vendor relations, finance strategy and business analytics.
Equity terms are not published.
Right for: a clinician-owner who wants a group run by clinicians rather than a pure financial buyer. Ask: the ownership structure of a partnership, what you keep at closing, and which of your systems change.
8Advanced Medaesthetic Partners (AMP)#
Advanced Medaesthetic Partners partners with med spas, plastic surgery practices and cosmetic dermatology practices. Its IGNITE partnership program has three tiers, ranging from operational support with vendor contracts, training and a peer network up to a full joint venture.
What stands out:
- A choice of depth. An owner can compare a light-touch option against a deeper partnership with the same group.
- Training standard. It states providers are trained through Allergan Medical Institute and its MDCodes methodology.
- Benchmarking. It lists AMP Intelligence, an analytics and benchmarking tool for its network.
Right for: owners who want to compare a no-sale option against a joint venture before deciding. Ask: what each tier costs, what equity changes hands in the deeper tiers, and who appoints your medical director and managers.
9MedSpa Partners (MSP)#
MedSpa Partners calls itself an acquirer of medical aesthetics practices in North America. After closing, its central team covers marketing, HR, business intelligence, payroll and accounting, procurement, real estate, legal, recruiting, training and education, a call center, IT and compliance. It describes a customized integration plan for each practice and a Chief Clinical Officer who works with a clinical advisory board to share best practices.
Its FAQ, as described in our private equity platforms guide, explains equity rollover and its step-by-step sale process.
Right for: an owner ready to sell and hand off most business functions while staying on as a provider. Ask: the split between cash and rollover equity, your role after closing, and which systems change in the first 90 days.
10Spa Medicca#
Spa Medicca partners with med spas and aesthetic and wellness practices through customized structures for owners who want a long-term growth partner or a full exit, and offers access to capital without personal debt. Its central support team handles HR, compliance, inventory management, EHR and AP/AR. Its brands include Amy Brenner, MD & Associates and Skin Science Aesthetics.
Because its central team manages the EHR, expect a software change after partnering.
Right for: owners who want options from a growth partnership to a full sale. Ask: the cash and equity mix, and which of your systems and vendors change in the first 90 days.
Questions to ask any med spa MSO
- Do I own the MSO, or do you? Build-your-own services leave you as owner. Platforms usually buy part or all of it. Get the cap table in writing.
- How is the management fee set? Flat, percentage of revenue, share of growth or cost-plus. Ask your attorney whether the fee is consistent with fair market value and your state's fee-splitting rules.
- Who owns the PC, and what if that physician leaves? Ask how a replacement physician is found and what agreements tie the PC to the MSO.
- Who makes clinical decisions? Treatment protocols, delegation, prescribing and patient care belong to licensed providers and the medical director, not the MSO.
- Who owns patient records and the patient list? Ask what happens to records, phone numbers and online accounts if the relationship ends.
- How do I leave? Term, notice, buyout or unwind cost, non-compete and what happens to your team and contracts.
- Will you sign a BAA? Any company that touches patient records, intake or billing should.
Where Prospyr fits
An MSO structure splits the business from the medical practice, but your team still needs one place where bookings, charts, payments and reporting live. Prospyr keeps online scheduling, aesthetic charting, payments, memberships and inventory on one patient record, with analytics and multi-location reporting an MSO can use to track revenue by provider and location. Check with your attorney how records and accounts should be held between the PC and the MSO, then book a practice demo to see how it works.
Frequently asked questions
What is an MSO in healthcare?
An MSO in healthcare is a management services organization: a company that provides business services such as staffing support, billing, purchasing, marketing, technology and facilities to medical practices under a management agreement. The licensed practice keeps clinical control. MSOs are common in physician, dental and aesthetic groups.
Do I need an MSO to own a med spa?
It depends on your state and your license. In states with strict corporate practice of medicine rules, a non-physician usually owns the business through an MSO while a physician owns the medical practice. In other states, nurse practitioners or other professionals may have more options. Confirm with a healthcare attorney before you form anything; our med spa licensing guide is a starting point.
What is a friendly PC?
A friendly PC is a professional corporation owned by a licensed physician who works closely with a non-physician owner's MSO. The PC holds the medical side and the MSO provides business services to it under a management agreement. The rules on how the two can be tied together vary by state.
Is an MSO the same as selling to private equity?
No. You can own an MSO yourself, hire one as a service, or sell to a private equity platform that runs its practices through its own MSO. Several companies on this list sit in between. See our management companies list and private equity platforms guide.
How much does a med spa MSO cost?
Most companies here do not publish fees. MedGrid MSO quotes per clinic on a 12-month term, Obsidian advertises a flat fee, and Upkeep Ventures states it is paid only on growth above your baseline. Platforms that take equity are paid mainly through ownership. Ask every company for a written fee formula.
Want your company considered?
We review this list quarterly. MSOs and platforms that partner with med spa owners can send their website and what they offer practices to info@prospyrmed.com. Inclusion is editorial and not paid.
Editorial scope
This list is based on each company's public website, checked October 2026 with AI-assisted research. Companies did not review this article before publication. It is not legal, tax or financial advice, a guarantee of results, or a substitute for checking references and having your own attorney and accountant review your agreements. Read our methodology or report a correction.