Spine and orthopedic leaders are optimistic about ways to grow their practices in the next 12 months.
Top opportunities include physician partnerships, leveraging artificial intelligence and exploring more ways to deliver patient care.
The 19 leaders featured in this article are speaking at Becker’s 22nd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, set for June 18-21 at the Swissotel Chicago.
To learn about participating in future events, please contact Carly Behm at cbehm@beckershealthcare.com.
As part of an ongoing series, Becker’s is connecting with healthcare leaders who will speak at the event to get their insight on thought-provoking questions within the industry. The following are answers from event speakers, lightly edited for clarity.
Question: Where do you see the best opportunities to expand your practice in the next year?
Brian Bizub. CEO of Raleigh (N.C.) Orthopaedic Clinic: Practices should be built around a patient-centered model that prioritizes access and convenience, including same-day and next-day appointments with physicians. Commitment to delivering a unique and engaging experience in MSK care, with a strong focus on patient satisfaction and active engagement throughout the care journey.
Partnering directly with employers through value-based MSK care bundles and coordinated care models that emphasize quality, outcomes, and cost-effectiveness.
Integrate advanced technologies — including AI — to drive operational efficiencies across the organization, from streamlining preauthorization processes to optimizing denial management workflows to AI ambient platforms for progress and operative notes.
Every practice commitment should extend to fostering a whole-practice culture that supports collaboration, innovation, and excellence at every level. As growth occurs, remain focused on becoming the one-stop MSK destination in the communities served.
Tyler Calvi. Digital marketing manager at Proliance Surgeons (Seattle): One of the most promising areas for growth in the next year lies in the continued evolution of data-driven marketing strategies. We’ve seen significant advances in how AI and big data can be used to refine patient targeting—allowing us to identify and reach individuals who are most likely to need our specialized care. This level of precision dramatically reduces wasteful spending by minimizing outreach to those outside our target population.
By leveraging these technologies across media campaigns, direct mail, and digital marketing efforts like SEO (Search Engine Optimization) and SEM (Search Engine Marketing), we must not only improve efficiency but also increase patient engagement and access to care. We’re already utilizing several of these tools, and I see this as a major area of expansion—not just over the next year, but as a long-term growth strategy over the next five years.
Janet Carlson, MSN, RN. Vice president of ASC operations at Commonwealth Pain & Spine (Louisville, Ky.): The best opportunities for our team at Commonwealth Pain & Spine to expand our practice, is by partnering with regional physicians in underserved markets to provide improved access for chronic pain patients. Another way to expand our patient care platform is to partner with local hospitals that have decided to downsize their internal pain management service line. We offer a solution that fits the needs of the community. Pain management patients are often disenfranchised as such, we treat these individuals with compassion and dignity as we seek solutions to reduce their pain and to assist them in increasing their activities in daily living. We are also very excited about our new Ambulatory Surgery Centers that are coming online as we speak. This will offer our patient population the opportunity to seek affordable, accessible, high-quality, and timely care for surgeries and interventions aimed at minimizing their chronic pain and improving their overall quality of life.
Andrew Fanous, MD. Inova Alexandria (Va.) Hospital: The primary opportunities for expanding my practice in the coming year will center around leveraging advanced technology to provide patients with the most effective and minimally invasive treatment options. As technological advancements continue, minimally invasive procedures have become increasingly attractive due to their ability to offer faster recovery times and lower surgical risks. Next month, we will be launching our spine endoscopy program at Inova Health System, offering cutting-edge, ultra-minimally invasive surgical solutions for patients throughout Northern Virginia and the broader DC Metropolitan Area. Additionally, we are expanding our motion-preservation surgical options, including cervical and lumbar disc replacement, both of which serve as compelling alternatives to traditional spinal fusion, particularly for younger patients.
Alfonso del Granado. CEO of Covenant High Plains Surgery Center (Lubbock, Texas): Broadly speaking, I think the opportunities remain strong for ASCs around the country in total joints (knees and hips), with or without robotic assistance. The protocols are well established and few (if any) patients need 23-hour observation. I also see a continuing opportunity for orthopedic spine surgeons and neurosurgeons to adopt minimally invasive procedures which, if not yet reimbursed better by payers, may still lead to both better outcomes for select patients as well as differentiating the ASC from its competitors. In the field of pain management, the newest generation of implantable pain stimulators is able to modulate the signal based on feedback from the patient’s neural response and early results suggest this may be a game-changer for patients as well as ASCs looking to offer the newest technology. These three opportunities in ortho, spine, and pain management continue the greater trend toward bringing cases of increasing complexity and higher acuity to the ASC environment.
Brandon Hirsch, MD. DISC Sports and Spine Center (Newport Beach, Calif.): I am in a somewhat unique practice environment, having begun an independent practice in a highly saturated and competitive part of Southern California in late 2024. As a result, practice expansion is on my mind on a daily basis. Over the next year I envision my practice expanding its digital presence, creating educational content for both patients and other medical professionals. While many terrible things happened as a result of the pandemic, one of the silver linings was the expansion of telemedicine. I believe this is an excellent way to provide patients access to specialist consultations from the comfort of their home. We plan to make this a major focus of our practice as it grows in the coming year.
Severko Hrywnak, MD, Chief Executive Officer, Advanced Ambulatory Surgical Center (Chicago): Same day orthopedic procedures. Expanding into outpatient joint replacements and arthroscopic procedures, which are increasingly preferred over inpatient surgeries. Along with more minimally invasive procedures that will attract more patients.
Nikolas Jannetta. Director of operations at National Spine and Pain Centers (Miami): While having the best people, systems, equipment, and facilities is essential, it is simply not enough to guarantee long-term success. The spine space is dynamic and constantly evolving. If you do not address the needs of the changing market, you will get left behind. Strategic partnerships and off-market deals can only be secured by positioning yourself as a credible and worthy collaborator. In this industry, that means consistently driving growth through new revenue streams, being known as forward-thinking, and retaining quality, talented clinicians that drive patient care forward through new care models and specialty procedures. Whether through mergers and acquisitions or other strategic relationships, rapid expansion and local market domination is possible for those who demonstrate the ability to discern between a fleeting fad and a solid, stable strategy for the future.
Earl Kilbride, MD. Orthopedic Surgeon at Austin (Texas) Orthopedic Institute: As we move into a non-narcotic era of practicing medicine, we must come up with alternative measures to take care of patients. In my practice, I have incorporated peripheral nerve stimulation into patients, either postoperatively or as an alternative to surgery. Along those same lines, things such as cryoablation and nerve blocks are becoming more common and orthopedics. My practice is no different, and I plan to incorporate some of these modalities to take care of patients on the orthopedic spectrum.
Sebastian Ksionski, MD. Medical director of Centra Southside Pain Clinic at Centra Health (Lynchburg, Va.): Being a regional center of excellence regarding pelvic pain management and interventions we at the Centra Pelvic Pain Center are expecting phenomenal growth as we help this underserved population. Using integrative modalities as well as producing robust outcomes is the reason for not only our regional growth but also our profitability. Opportunities and use of newer and cutting-edge procedures/therapies is key to keeping up with newer therapies and is vital to growth. As well as fostering these referral patterns and meeting expectations of not only our patients but also our referring providers is paramount; and an opportunity to develop and grow our, or for that matter, any pain practice.
Lisa Leathers, RN, BSN. Administrator at Surgical Center at Columbia (Mo.) Orthopaedic Group: Our ASC continues to pursue site of service shift opportunities. Having moved most of our eligible total joint volume to the ASC, we are now focused on increasing spine volume. We are also expanding pain management services into our ASC space through a planned procedure suite expansion project. Our community is underserved currently with respect to pain management access and the expansion will facilitate practice recruitment efforts in the market while growing the ASC revenue stream.
Jeff Lehmen, MD. Spine surgeon at SSM Health Spine Surgery Center (Jefferson City, Mo.): I think the best way to expand my practice over the next year is to continue to move to outpatient spine surgery. We’ve already been doing a complex spine with 23 hour discharge, however, the insurance companies many times will mandate the patients stay overnight depending on certain CPT codes that really don’t change the surgery that much. Lobbying for the insurance companies to approve more of these surgeries on an outpatient basis is really the way to expand and improve outcomes more importantly.
Brett Maxfield, CRNA. Director of Anesthesia and Surgical Services at Teton Valley Health Care (Driggs, Idaho): Our facility primarily specializes in small joint orthopedics, specifically hand and podiatry, so we have growth opportunities in different areas than other larger, orthopedic and spine practices. Currently our two best avenues for growth in the coming months and years are first, adding additional volume through networking with primary care providers and adding additional surgeons, and second, through building and strengthening our relationship with our various product distributors and representatives in order to decrease our total overhead and increase our net revenue. The combination of increasing volume and decreasing expense makes us hopeful for continued growth moving forward.
M. Craig McMains, MD. OrthoIndy (Indianapolis): Honestly, the biggest opportunity for growth is just taking better care of patients – it sounds simple, but it’s everything in spine surgery. Patients talk, and they remember how they felt throughout their entire experience with us. I’m really focused on measurable improvements at every touchpoint, whether that’s getting them seen faster through our urgent care network or tracking real outcomes with patient-reported measures. Our endoscopic spine program has been a game-changer here – patients are amazed when they’re walking around the same day after surgery that used to keep them down for weeks. When you consistently deliver that kind of experience, patients become your best marketing team. The practices winning long-term are the ones proving better results, not just promising them.
Melissa Rice. Administrator at Loyola Ambulatory Surgery Center (Oak Brook Terrace, Ill.): In the next year, I see significant opportunities for expansion in several key areas. First, optimizing operational efficiencies through advanced technology and streamlined processes will be crucial. This includes leveraging AI and automation to enhance patient care and administrative workflows.
Secondly, there’s immense potential in expanding outpatient services, especially in specialties like orthopedics, spine, and podiatry. As patient preferences shift towards outpatient care, enhancing our ASC’s capabilities in these areas will be a strategic move.
Thirdly, focusing on strategic partnerships with payers and providers to enhance managed care contracts and revenue cycle management will be vital. This involves negotiating favorable terms and ensuring seamless billing processes.
Lastly, investing in staff development and training to maintain high standards of clinical excellence and patient satisfaction remains a priority. By fostering a culture of continuous improvement, we can ensure sustainable growth and quality outcomes in the coming year.
Zeeshan Tayeb, MD, owner of Pain Specialists of Cincinnati: As a big supporter of privately owned physician owned groups, allianceing your group with entities that can offload some of the administrative tasks is essential. In my own group I have partnered with vendors to help relieve the administrative burden to my staff and myself. This transition has allowed me to focus more on patient care and spend time on passion projects like research and teaching. As the medical landscape continues to change and reimbursements decline, I see that there will be more reliance in the coming year on vendor collaborations. Those vendors have changed from person-to-person interactions, and we now interact with many AI platforms, which is where I see the best way to expand a practice in the coming year. Implementing AI as part of your team can help reduce the hours we spend on reviewing charts, gathering data, pulling reports and applying algorithms to the plan of care for our patients.
Maria K. Todd, PhD. Director of business development at Red Rocks Surgery Center (Golden, Colo.): Patient redirection. In the next year, the most strategic growth opportunity lies in going direct to plan administrators and fiduciaries — completely bypassing middleware vendors ASOs and TPAs that add cost, dilute value, and control all steerage. Spine, pain, and ortho practices positioned with clean bundled pricing and concierge-level coordination, and agree to prepayment in full prior to case commencement are exactly what these self-funded buyers need and want. But unlocking that channel requires fluency in ERISA and Taft-Hartley fiduciary obligations, especially around prudence, transparency, and duty of loyalty. Middleware vendors can’t deliver that alignment — they’re just tollbooths. When you remove them from the equation, you control the relationship, the margins, and the profit. Find plan administrator/fiduciary contact details on Section 3 of their IRS Form 5500s.
Katherine Wagner, MD. Neurosurgeon at Ventura (Calif.) Neurosurgery: I am looking forward to expanding my endoscopic spine practice. I am also excited to offer patients lumbar facet arthroplasty and continue to focus on motion preserving surgery in the near future.
Corey Welchin, DO. Owner of Center for Specialty Care (Fairmont, Minn.): Our opportunity to expand is through marketing and networking. We are talking to a couple different general surgery groups, recruiting podiatry, doing SEO marketing/ postings for orthopedics and spine pain, and we continue to grow in the pain injection area.
