Dr. Alexander Vaccaro's plan to win in new markets with value-based care

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On Sept. 22, 2020, Philadelphia-based Rothman Orthopaedic Institute inked its partnership with Orlando, Fla.-based AdventHealth to expand into the Florida market. Rothman's president, Alexander Vaccaro, MD, PhD, spoke with Becker's about how that push stands a year later and what's in store in the coming months.

Note: This conversation was edited for style and clarity.

Question: What are the latest developments regarding Rothman’s presence in Florida? What can we expect in the coming months into 2022?

Dr. Alexander Vaccaro: Right now, we have offices in Davenport and Winter Park, which opened on July 1. We have plans to open a Winter Garden location office on Sept. 23, as well as another location in the Lake Mary area in 2022. We just had pictures sent to us a few days ago of our headquarters, called the Lego Tower, in Orlando, that's going to open in 2022. What we're going to try to have is all the specialties. We have hand and wrist, we have trauma, we have orthopedic oncology, we have sports medicine and total arthroplasty. We're developing a spine service at the present time and a foot and ankle service.

Our leader now is a gentleman by the name of Daryl Osbahr, MD, and he is managing director and chief of orthopedic surgery. He's sort of overseeing everything. He's done a phenomenal job, and he used to be up in the Northeast. He had this proclivity to be an academic professor as well as the sports medicine doctor. He's the guy that we have in charge, and under his leadership, we just got named a DNV Center of Excellence for hip and knee replacements.

That's what we're doing now. What we basically did is we took our platform that we have in Southeast Pennsylvania, and we just exported the platform — sort of like a federated centralized model — where we govern centrally, but we have satellite offices in different states. We have service chiefs on a national basis, and then we have local chiefs that run the business locally. It's been working really well, and the relationship is great because we have a partnership with AdventHealth. They have the vision of healthcare, and that vision is basically navigational care, bringing people to lower-cost centers.

Q: You said in 2020 that you hoped to have 50 surgeons in Florida within five years and 85 in the next decade. How is Rothman tracking on that goal?

AV: We're at 13 physicians, which is ahead of schedule, and we just hired a very famous shoulder surgeon from the Northeast.

Q: Lately we’ve seen more interest from other orthopedic practices who want to expand to Florida. What’s Rothman’s strategy in competing with what will be a very busy market?

AV: I always liked competition because it allows us to understand the good things about our rivals. Rivals encourage us to be more competitive in terms of value-based healthcare. What do they do better than we do? Let's imitate the best in class, and let's try to beat them when it comes to quality of care and cost.

When you're the only one around in your area, you develop a sense of complacency, and I think costs go up. I encourage competition. Florida is a great market. Orlando is growing at an estimated 300,000 people per year, so the market is expanding, and they need healthcare, especially the aging population. I've always been a big supporter of competition. It sort of stimulates us at the Rothman Institute to be more competitive ourselves.

Q: Is there anything else you want to add that we haven't discussed?

AV: I think the big focus is we couldn't have done this without the support of AdventHealth and their vision on value-based healthcare. They really want to bring great care to the everyday person, and without their help and their leadership and their support, we couldn't have done it. We've really enjoyed working with their leadership.


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