10 Things to Know About ASCOA
1. ASCOA was founded in 1997 by Thomas J. Bombardier, MD, FACS; Brent W. Lambert, MD, FACS; and George A. Violin, MD, FACS. The three are all board-certified ophthalmologists.
Dr. Lambert was a member of the Harvard Medical School faculty and is founder of medical device company XONIX. He was the developer and owner of one of the first ASCs in New England. He is a graduate of Harvard University and the Columbia University College of Physicians and Surgeons and completed residencies at the Harvard Medical School and Massachusetts Eye & Ear Infirmary.
Dr. Bombardier, founder of the largest ophthalmic practice in western Massachusetts, has been developing real estate on Cape Cod, Mass., and is a graduate of Amherst College, Albany Medical College and Louisiana State University's residency program.
Dr. Violin developed multiple ASCs before co-founding ASCOA. He is a graduate of Columbia College, the Columbia University College of Physicians and Surgeons and Harvard Medical School and Massachusetts Eye & Ear Infirmary residency program.
2. The company began as three centers located in the Boston area. The earliest additional centers were de novo or new construction developments, with the company's first joint venture development occurring in 2000.
3. Currently, the company is led by CEO Luke Lambert, MBA, CFA, CASC; COO Laurie Hendrix, BSN, RN, CASC; CFO Robert Westergard, CPA; and CDO Dr. Lambert, with input from Drs. Bombardier and Violin. ASCOA's CEO, Mr. Lambert, is among the first in the ASC industry to achieve a CASC, according to the company, and received his MBA from the Columbia Graduate School of Business.
4. In total, ASCOA has developed more than 65 ASCs in 17 states. It currently operates 31 facilities nationwide. One success story comes from a Texarkana, Texas single-specialty center opened in 2005. The physician owners went through three different management companies before connecting with ASCOA in 2011. Two months after ASCOA assumed management, the physician partners received their first distributions and within the first four months ASC case volume increased 66 percent; revenue increased 63 percent. ASCOA helped the center add spine, ENT and ophthalmology.
5. ASCOA is one of the approximately 30 chains nationwide with investment in more than 10 ASCs (11 Things to Know About ASCs). The majority of the company's early centers were de novos, but since 2009 the company has seen the most growth in joint venture projects. Some of these joint ventures are in the most competitive markets in the country. As consolidation in the healthcare industry continues, it will be interesting to see how ASCOA's business model evolves to meet the changing needs of their partners.
6. ASCOA's centers include five joint ventures, 19 turnarounds and 40 de novo centers. The joint venture centers include: Surgery Center of Midwest City (Okla.), Hudson Valley Ambulatory Surgery (Middletown, N.Y.), Manhattan Surgery Center (New York City), New York Eye and Ear Infirmary Surgery Center of Bayside (N.Y.) and an additional center being developed in the Bronx, N.Y. In Midwest City, Oklahoma, ASCOA helped their joint venture successfully navigate a partnership with a new hospital and a water main break, while maintaining volumes and profitability.
7. For joint ventures, partnerships are available for both hospital-associated and non-hospital physicians. In its joint venture partnerships, ASCOA and the hospital typically own both 25 percent of the center, with physicians owning the other 50 percent. While hospital joint ventures are a minority of ASCOA's total business, the company has seen an increase in joint venture projects since 2009.
8. ASCOA has partnerships with both single-specialty and multispecialty centers. The majority of its centers are physician-owned without a hospital partner. One example of ASCOA's positive relationships with community physicians comes from Athens, Ga., where ASCOA purchased a certificate of need with only four months left for development from an ASC company that had not been successful partnering with local physicians.
9. The company's traditional business model involves investing at 30 percent as a minority partner and physicians owning the remaining 70 percent of the center. The model includes a management contract; ASCOA does not manage centers it does not own. Within the ASC company industry, nearly 50 percent of companies prefer less than 30 percent ownership (Healthcare Appraisers 2014 ASC Valuation Survey).
10. ASCOA prides itself on efficiency, which is evident in its business model: "We found ASCOA’s efficiency produced an extra day of time on average in a 5-day week. A surgeon performing 200 cases per year could do 300 cases under the ASCOA model—all other things being equal," according to David J. Abraham, MD, a surgeon at The Reading (Pa.) Neck & Spine Center.
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