The consolidation of physician practices and ASCs by hospitals, health systems and private equity persists in markets across the U.S. However, some ASC physicians and leaders sense a growing push towards independence as physicians fight for their autonomy and practice ownership.
As a result, a number of practice ownership and management models have emerged that view independence as a point of strength, opting out of traditional acquisition models.
Here are seven ASC development companies and management services organizations leading the independence wave in ASC M&A:
1. ASCend: A new MSO based in Gillette, Wyo., whose mission is to keep rural ASCs independent and locally owned. Founded by CEO Linda Bedwell and COO/CFO Norberto Orellana, ASCend aims to empower physician-led surgery centers in underserved regions. ASCend also has a physician development program that physicians can complete and return to participating states, Ms. Orellana told Becker’s.
“ASCend isn’t here to criticize or judge. We say: ‘Look at what you’ve achieved with limited resources. Now let us help you go further.’ We want to help centers that are operating in ‘average’ move into ‘massive action’ and get results they couldn’t achieve alone — not from lack of effort, but because they lacked resources and expertise,” she said. “That’s who we are. That’s what we do. Any ASC out there thinking, ‘We’re surviving, but we want to do more,’—that’s where Ascend comes in. We can help them go beyond average.”
2. Capital Surgical Solutions: After witnessing the changes at a former employer when the organization was bought out by a larger company, Benjamin Stein, MD, an orthopedic surgeon, co-founded Capital Surgical Solutions. The company saw major success with its first two centers, particularly related to satisfaction and patient outcomes. The independence-focused model has also resulted in higher staff retention, a difficult feat in today’s market.
“I believe our staff value how we prioritize listening to our teams, ensuring that management decisions, such as clinical services and operating times, are made in partnership with our doctors and staff,” he said. “We’re committed to providing competitive compensation that reflects the exceptional talent we seek to attract and retain. While we manage our labor effectively, we never compromise on quality.”
3. ReKlaim Health: Founded by Dutch Rojas, also CEO and founder of Physician Capital Inc., ReKlaim seeks to build a “national coalition” of independent ASC and physician-owned hospitals through physician ownership, shared infrastructure and “union-style economics.”
“The general idea is, how do you become the all-in-one platform for business services?” he said. ReKlaim supports physician-owned practices in a number of ways, but principally by bundling risk across employee benefits, property, casualty and malpractice insurance to cut down on physicians’ insurance and benefits costs. ReKlaim helps these groups consolidate administrative workloads, including payroll, revenue-cycle management and compliance through systems that remain in physicians’ control. It also aims to strengthen practice finances through direct employer contracts and private labeled, self-funded employer plans and access to capital markets.
4. Sapient Health: Based in New York City and owned by Joseph Romano and Bill Ingram, Sapient has “the expertise of a large management company while maintaining a personalized, startup-like feel,” Mr. Romano told Becker’s. The company emphasizes regional representation, particularly in New York, New Jersey and Florida. They also operate a physician-driven model in which the firm enters deals as a minority partner, ensuring that physicians retain leadership while gaining business acumen for long-term success.
5. Redefine Management: The Matawan, N.J.-based MSO utilizes a vertically integrated model to offer a full spectrum of tailored management solutions, empowering physician groups and healthcare providers with the infrastructure they need to succeed. Redefine’s CEO William Vanderveer told Becker’s that, through the company’s partnerships with medical groups, his company is able to deliver the benefits of traditional health system alliances, like more favorable payer contracts, while preserving physician autonomy and independence.
6. CardioOne: The Houston-based, cardiology-focused MSO provides ongoing infrastructure support to its partners, specifically in IT, revenue cycle management, benefits administration, finance and credentialing through a master services agreement. CardioOne does not acquire, own or employ any of the practices it works with. Rather, it partners with groups of cardiologists, especially those who are currently employed and looking to start an independent practice, and supports them in every aspect of starting a business.
7. Atria Health: The Philadelphia-based platform is an independence-forward partnership model for cardiology practices. While Atria is backed by Cypress Ridge Partners, a private equity group, the company does not acquire practices, but rather invests in them to support long-term goals and growth. Atria recently partnered with Philadelphia-based AMS Cardiology, an independent cardiovascular practice of over 40 years, and launched an ASC through the joint venture.
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