Bon Secours Mercy Health, Compass Surgical Partners and a group of local physicians recently opened a new orthopedic ASC in Newport News, Va.
The center marks another milestone in the partnership between Cincinnati-based Bon Secours and Raleigh, N.C.-based Compass Surgical Partners, which joined forces in 2023 to expand outpatient surgical care. Their long-term goal is to develop 30 ASCs across multiple states.
Compass Surgical Co-Founder and President Sean Rambo joined Becker’s to discuss how the partnership creates a model for physician-led growth and why Virginia’s unique regulatory landscape made it possible.
Editor’s note: This interview was edited lightly for clarity and length.
Question: What made coastal Virginia and orthopedics the right place to grow your partnership with Bon Secours?
Sean Rambo: Over the last three decades or so, we’ve seen outpatient surgery steadily move from the hospital setting into ASCs. Orthopedics continues to lead that shift — we’re seeing more complex cases, from total joints and spine to basic sports procedures, being performed safely outside the hospital. From our perspective, it’s an ideal specialty to start with.
With the involvement of an independent group and our existing relationship with Bon Secours, the project created an opportunity to migrate a lot of the health system’s Medicare business — which had been confined to the hospital due to licensing — into the ASC setting. It created the opportunity to move that book of business out, and allowed the physicians to expand and continue to grow their practice.
Q: How would you say this partnership helps Compass and Bon Secours stand out in the region, competitively?
SR: With Bon Secours, this creates an alignment where the physicians themselves now have a vehicle to remain independent while also gaining access to a partnership with a health system that would otherwise possibly not be there.
Q: Can you explain how the joint venture is organized, and how that balances keeping physicians independent while gaining the benefits of health system partnerships and leverage?
SR: All of our partnerships are physician-driven and physician-led. Within the partnership and the surgery center, all the clinical decisions are made by the people who know them best — the physicians.
There are elements of control that the joint venture holds — from purchasing power to bringing additional access points to independent physicians, such as ACOs or networks. But at the core, decision-making remains in the physicians’ hands.
From a Compass perspective, we partner in two types of centers. We have independent centers with just Compass and physicians, and we also develop centers in partnership with health systems. Both models have their place and depend heavily on the service area.
In service areas with heavy independent competition and multiple health systems, the independent model works better. In markets with fewer health systems, aligning with one tends to create more value for physicians — allowing them to stay independent as a group while gaining broader access without directly competing with employed groups.
That’s really why we focused on this geography and this group. It checked all the boxes. We’re really excited to partner with Bon Secours Mercy in Virginia, not just in Hampton Roads but also evaluating similar partnerships in Richmond and surrounding areas.
With the [certificate-of-need] laws in place, outpatient surgery is underserved and has an opportunity to migrate more out of the hospital setting. That’s what makes this partnership and service area so exciting for us.
Q: How did CON laws shape this deal?
SR: This was a somewhat unique scenario. Virginia has a loophole in its licensing process — physicians can build what’s called an “operatory” without a CON, but it’s limited to commercial cases and isn’t eligible for Medicare participation. It essentially looks and operates like a surgery center but can only serve commercially insured patients.
With Bon Secours, they already had an existing CON in another part of the market that they could contribute. There wasn’t a new CON application, just a transfer. That allowed us to acquire the business and convert it into a fully licensed surgery center, enabling both commercial and Medicare cases to move out of the hospital.
