Demystifying the challenges of MACRA

With over 100 years of providing physicians leadership and guidance, the California Medical Association, the Texas Medical Association and the Florida Medical Association bring you experience to help navigate the new MACRA requirements including an easy-to-use Action Plan.

Start Your Journey
Female Physician

Management Team


Lance R. Lewis, MBA

Lance R. Lewis, MBA

Chief Executive Officer
PSO Services, LLC

Lance R. Lewis is Chief Executive Officer of PSO Services, LLC, a national healthcare solutions company that offers products and services to help independent physicians take advantage of value-based contracts by improving quality and lowering cost. He is the company's first CEO.

Mr. Lewis is also the Chief Operating Officer of the California Medical Association (CMA), a nonprofit organization representing more than 43,000 licensed physicians and surgeons in the State of California. Mr. Lewis has direct responsibility for the administrative and operational support centers of the organization. These functional areas include the Departments of Finance and Administration, Membership Dues Accounting, Human Resources, Information Technology and Facilities Management.

Mr. Lewis maintains a relentless focus on the cultural interaction between individuals and teams across the entire company by emphasizing the need for teamwork. He does this by persuading others to see themselves as integral to achieving the company’s goals and by creating enthusiasm for tackling obstacles to success through cooperation, mutual reliance and accountability.

During his tenure as COO of CMA, Mr. Lewis has transformed the budgeting process from a traditional method to an activity-based costing model, orchestrated the sale of a subsidiary and created a perpetual endowment, and devised a new integrated Association Management System connecting CMA to 42 component medical organizations and related-subsidiaries.

Mr. Lewis was named CFO of the Year by the Sacramento Business Journal in 2017.

Mr. Lewis earned his Master’s in Business Administration (MBA) from the University of Southern California Marshall School of Business.


Dave Spalding

Dave Spalding, MBA

Chief Operating Officer
PSO Services, LLC

Dave Spalding is Chief Operating Officer of PSO Services, LLC, a national healthcare solutions company that offers products and services to help independent physicians take advantage of value-based contracts by improving quality and lowering cost.

Dave Spalding is also the Chief Operating Officer of TMA PracticeEdge, a company which he helped launch in February 2015.  In addition to standing up multiple, physician-led ACOs across the state of Texas, other key deliverables include implementing aligned vendor partnerships, development of the inaugural strategic plan, and establishing a suite of turnkey solutions for physician clients.

Prior to TMA PracticeEdge, Mr. Spalding was a business development executive at Health Care Services Corporation (HCSC) and Blue Cross-Blue Shield (BCBS) of Minnesota where he had accountabilities for managing service subsidiary business units.

He has had instrumental leadership roles in building several start up healthcare businesses including a population health provider with over 250,000 patient lives, a successful HSA trustee with over $800 million in deposits and a five star Medicare Part D administrator.  Mr. Spalding has additional experience in governing joint venture investments for strategic investors including the roles of board chair for of Availity LLC, director of a national telehealth network company and director of an acute care hospital.  On the mergers and acquisition side, he has led half-a-dozen middle market transactions totaling approximately $400 million including divestments of several provider-related assets.

Prior to his healthcare career, Mr. Spalding spent a decade in investment banking serving high growth, non-investment grade clients raising over $5 billion in financing.

Mr. Spalding has an international finance MBA from Thunderbird in Phoenix, AZ and a Bachelor of Arts in Asian Studies from SUNY at Albany.


Jeffery M. Scott, Esq.

Jeffery M. Scott, Esq.

General Counsel
PSO Services, LLC

Jefferey M. Scott is General Counsel for PSO Services, LLC, a national healthcare solutions company that offers products and services to help independent physicians take advantage of value-based contracts by improving quality and lowering cost.

Mr. Scott is a graduate of the University of Southern Mississippi where he received his Bachelor of Science Degree in Political Science.  Mr. Scott received his Juris Doctor degree from the Florida State University College of Law where he was a member of the Law Review and Order of the Coif.  He is licensed to practice law in the State of Florida, U.S. District Court for the Northern District of Florida, U.S. District Court for the Middle District of Florida and U.S. Eleventh Circuit Court of Appeals.

Mr. Scott began his law career as a litigation associate with Collins, Shipman & Lucas, P.A., practicing insurance defense with an emphasis on medical malpractice litigation.

Mr. Scott is General Counsel for the Florida Medical Association (FMA). A 20-year veteran of FMA, Mr. Scott previously served as Assistant General Counsel and Vice President of Legal and Governmental Affairs. He currently oversees all legal affairs of the Association and plays an integral role in the lobbying and governmental affairs of the FMA.