The next growth phase for 6 large orthopedic groups

Practice Management

Engaging in risk-based contracts, expanding ASCs and ancillary services and capitalizing on the shift of higher-acuity spine and joint replacement surgeries to the outpatient setting are among the biggest opportunities for growth in orthopedics.

Six orthopedic practice leaders told Becker's how they aim to grow in the next year:

Editor's note: Responses were lightly edited for length and clarity.

Bruce Cohen, MD. CEO of OrthoCarolina (Charlotte, N.C.): We are strategically planning to grow our footprint regionally. We continue to look for opportunities that complement our current structure and coverage. A significant focus is on the ability to deliver value-based care and manage musculoskeletal population health. This requires regional growth and coordination. We also continue to grow our current practices to meet the needs of the communities that we currently serve. Finally, we are focusing on increasing our ambulatory surgery access and capacity and optimizing this critical service line.

Alex Vaccaro, MD, PhD. President of Rothman Orthopaedic Institute (Philadelphia): We're expanding pretty rapidly. When we think about expansion, we examine a particular geographic location and what the orthopedic landscape is like. Some areas have a great orthopedic landscape; the communities are being serviced well, they've got great value-based programs and surgeons that buy into that philosophy. If that's the case, we feel that we may not provide further value. We go into places that may be a little bit behind when it comes to  innovative value-based bundled payment programs, outpatient ambulatory care services, or there is fragmented care delivery. Those are prime markets we think are appropriate to expand into.

Frank Aluisio, MD. Physician president of EmergeOrtho Durham, N.C.): I see us potentially adding small groups into the fold without diluting leadership and also managing small groups either alone or in conjunction with other large groups. North Carolina is a certificate of need state, so you can't open ASCs easily. There have been attempts over the past decade to get rid of CON legislation, so hopefully something will change soon. If that happens, we'll certainly expand into more ASCs. But right now we plan on doing a lot of our expansion through orthopedic urgent care and physical therapy facilities.

J. Bryan Williamson, MD. Medical director of OrthoLoneStar (Houston): We are planning to grow and expand access to our services through opening additional sites of service, bringing on new providers, expanding into adjacent geographies and adding integrated treatment options. We will launch orthopedic bundles and institute value-based pathways. We plan to create a workplace environment for our employees and orthopedic partners that puts the patients' interests first.

Nicholas Grosso, MD. President of the Centers for Advanced Orthopaedics (Bethesda, Md.): We will be implementing our first risk-based contract through Maryland's Episode Quality Improvement Program and aim to sign one to two more risk-based contracts by the end of 2022. We will continue to build and invest in the infrastructure needed to succeed with risk-based contracts. This will not happen overnight, but we are prepared for delayed gratification as we make this exciting transition.

Ed Hellman, MD. President and interim CEO of OrthoIndy (Indianapolis): Clearly we need to develop and expand our outpatient strategy because just like the community hospital down the road, procedures are going to move out of the hospital to an ASC. We need to have those ASCs positioned in the community where we can serve patients close to home, efficiently and with a positive margin as we move out of the hospital. That's likely our biggest potential for growth. We're looking at a hub-and-spoke model. I think having clinics that are closer to home that can provide services where patients live and work and bringing only the higher-acuity procedures to our main hospital location makes the most sense.

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