Meridian Surgical Partners is a leader in outpatient spine and bringing spine procedures to the ambulatory surgery center setting.
Meridian Surgical Partners was founded in 2006 by Kenny Hancock, president and chief development officer, Cathy Kowalski, executive vice president and chief operating officer, Jim Uden, executive vice president and chief financial officer and John Wilson, chief executive officer. In March 2006, Meridian was funded by a private equity group and acquired its first three ambulatory surgery centers (Coral Gables Surgery Center, Miracle Hills Surgery Center and Foothill Surgery Center).
By 2011 Meridian Surgical Partners had developed and acquired controlling interests in 16 ASCs. Currently the Company has interests in 11 partnerships operating in 10 ASC locations across the country. Of those, six are multi-specialty, one is orthopedics and three are spine-focused ASCs.
Here is expertise from the leaders at Meridian Surgical Partners discussing the drivers of outpatient spine cases and where the centers are headed in the future.
Q: Meridian is one of the true leaders in spine. What is the future of spine in ASCs?
Spine will continue to migrate to an ASC setting along with other higher acuity surgical procedures. The vast majority of spine surgery is currently performed in hospitals. High-quality patient outcomes, combined with lower surgical costs, will continue to drive spine to ASCs. In 2015 Medicare developed a fee schedule for spine in an ASC setting for the first time. The acknowledgement by CMS that spine can be performed safely in an ASC will continue to drive spine surgery to an ASC setting.
Q: What are the drivers of spine to ASCs?
There are multiple market drivers that are creating the shift in spine surgical cases from an inpatient to an ASC setting. Some of the most significant are advancements in technology, anesthesia and techniques, a "minimally invasive mindset" among surgeons, patients and the medical device industry, payer acceptance and emerging post-surgical recovery options (skilled nursing and home care). The industry consensus is that high-quality, cost-effective spine surgery can be performed safely with positive outcomes in an ASC.
Q: What are the biggest challenges to spine in ASCs?
Reimbursement – making sure that the ASC is paid adequately for spine surgery. Until this year, there was no spine fee schedule for Medicare in an ASC. Since the majority of commercial payers follow Medicare it has historically been a negotiation with the insurance companies to develop adequate case rates and to recognize spine may be performed in an ASC safely. Another major challenge is reimbursement of implants — without an arrangement to cover spine implant costs, performing spine in an ASC setting is cost-prohibitive.
Q: What other specialties is Meridian Surgical Partners keenly focused on and why?
More than 70 percent of the Company’s surgical case volume is focused in musculoskeletal surgery such as orthopedics, sports medicine and total joint replacement, spine and pain management. Other areas of specialty focus include ENT, ophthalmology and GI within multi-specialty offerings. All investments are made with a critical focus on future growth.