Why Florida is becoming a major battleground for orthopedics


Florida's population boom, tax-friendly nature and aging population all contribute to it becoming a key battleground for orthopedic practices. 

The state's population soared by more than 240,000 last year, second only to Texas, which gained almost 374,000 people, according to data published by the U.S. Census Bureau in December.

Coinciding with this population explosion, two major orthopedic groups based in the Northeast recently expanded into the Sunshine State, with more expected to follow in the coming years, as Florida is expected to become arguably the biggest territory for orthopedic care.

In January 2020, New York City-based Hospital for Special Surgery opened a 60,000-square-foot hospital in West Palm Beach, Fla., through a partnership with Dallas-based Tenet Healthcare. 

Philadelphia-based Rothman Orthopaedics is also capitalizing on Florida's population boom, partnering with Altamonte Springs-based AdventHealth and developing a $100 million headquarters in Orlando.

"I think you're going to see more orthopedic groups entering Florida in the future," Alexander Vaccaro, MD, PhD, president of Rothman Orthopaedics, told Becker's. "Florida is a playground for the young and is a popular place to live as we age. It's also a recreational community, so there's a lot of sports-related injuries."

Rothman Orthopaedics' expansion into Florida has been in the works for the past six years. The practice also considered Texas and California, which lost nearly 70,000 residents last year — the state's first annual population loss since 1850, according to U.S. Census Bureau data.

As a warm-weather state, Florida has a big recreational community and a lot of sports-related injuries. It also has a lot of people with aging orthopedic problems such as total joint replacement and spinal stenosis.

"Floridians, as they age, stay as active as they were when they were younger," according to Martin Roche, MD, director of hip and knee arthroplasty at HSS Florida in West Palm Beach. "I'm doing knee surgeries for people in their 80s that are playing pickleball, tennis and golf.

"The weather promotes a more active lifestyle, which their social bond with their friends and family is built around," he said. "It's also a much more tax-friendly state." Florida is one of nine states that does not impose income tax on its residents.

HSS, ranked No. 1 for orthopedics for 11 consecutive years by U.S. News & World Report, aims to become the top musculoskeletal provider across the U.S., Dr. Roche said. "I think Florida was its first test ground."

As orthopedic practices look to expand into warm-weather states like Florida, rising consolidation continues to be a trend in these areas. In the past year, three orthopedic supergroups were formed through mergers in Florida, Texas and Tennessee.

Florida Orthopaedic Institute in Tampa merged with Clearwater-based OrthoCare Florida in March to include 150 providers across 17 locations — the biggest orthopedic group in the state.

Furthermore, one of the biggest orthopedic hospitals in the country broke ground in Orlando last year. Orlando Health's Jewett Orthopedic Institute, a $189 million project, will have 75 beds, 10 operating rooms and an outpatient surgery center with an additional 10 ORs.

Sports medicine and trauma specialists were among the practices hit hardest during the pandemic as shelter in place and social distancing regulations led to a decline in activity levels. 

However, Florida was among the first states to loosen restrictions on recreational and youth activities, among others, which adds to the appeal for orthopedic practices.

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