New York City-based Hospital for Special Surgery, the nation’s top-ranked orthopedic hospital, is partnering with global growth investor General Atlantic to launch a new, independently operated national platform of ASCs focused on orthopedic and spine care.
As part of the initiative, HSS and General Atlantic are acquiring Plano, Texas-based Legent Health, creating an immediate foundation for scale and expansion.
The partnership aims to expand access to high-quality, lower-cost musculoskeletal care across the U.S., combining HSS’ clinical expertise with Legent’s established network of surgery centers, according to an Oct. 15 system news release.
Nearly 80% of orthopedic procedures are now performed outside hospitals, and HSS aims to bring its well-known quality and efficiency to that setting on a national scale.
“We recognize there’s a significant difference in outcomes, efficiencies and value when you build specialty-focused centers with the same consistency that has defined our inpatient orthopedics,” Bryan Kelly, MD, president and CEO of HSS, told Becker’s.
The platform has been in development for more than 18 months. It will operate independently under Legent CEO Jordan Fowler, combining HSS’s clinical expertise and governance with new investment and infrastructure to support expansion, development and acquisitions.
“This is something unique in the healthcare industry,” Dr. Kelly told Becker’s. “We’re creating a way to bring HSS-level care to more communities while preserving the quality that defines us.”
HSS brings 163 years of orthopedic experience and a network of nearly 2,000 surgeons who trained at the institution.
Dr. Kelly said the platform will draw heavily on that expertise, alongside HSS’s Ambulatory Development Network — a group of about 80 surgeons who have built standardized outpatient care pathways over several years.
A chief medical officer from HSS will oversee the platform’s clinical standards, ensuring that outcomes and safety protocols remain consistent across sites.
Governance and partner selection will be key, Dr. Kelly said, with HSS choosing only collaborators who share its commitment to quality and patient-centered care.
“We’re choosing ASC partners, hospital systems and surgeons who already meet our standards,” he said. “Picking the right partners and applying consistent governance is how we’ll maintain HSS-quality outcomes nationwide.”
The partnership immediately expands HSS’s presence in Texas and the South, where Legent operates 13 surgery centers and several specialty hospitals. Over time, the organizations plan to grow into additional regions where demand for orthopedic services is high and markets are fragmented.
“We think about this as a seven-to-10-year journey,” Dr. Kelly said. “We’re targeting markets where we can have the biggest impact — places with strong alumni density and opportunity to improve quality.”
While the platform’s near-term focus is physical expansion, HSS is planning a digital ecosystem that connects patients to orthopedic services earlier in their care journey.
That strategy reflects a broader reimagining of HSS as not only a surgical destination but a continuum of musculoskeletal health — encompassing prevention, rehabilitation, performance, lifestyle medicine and regenerative care.
The shift aligns with broader payment and policy trends accelerating outpatient migration, Dr. Kelly said.
“As commercial and federal payers continue pushing procedures to outpatient settings, health systems need to evolve,” he said. “We want to lead that shift — delivering care closer to home, more efficiently and with no compromise on safety or outcomes.”
Even as its ambulatory footprint grows, HSS will maintain its focus on complex inpatient procedures — including revision surgeries, trauma cases and pediatric orthopedics — at its Manhattan campus.
“The future of healthcare has challenges for everyone,” Dr. Kelly said. “But we think there’s a bright future for HSS. Our mission isn’t just to serve those who can travel to us — it’s to raise the national standard for musculoskeletal care.”
