For Raleigh, N.C.-based Compass Surgical Partners, the key to ASC success is not scale alone. It is independence, intentional partnerships and agility.
Independent physicians are on the decline, and staying independent is more difficult than ever. Small groups often struggle with contracting, care coordination and risk-based arrangements, making infrastructure and scale increasingly essential.
“Independent physicians are really in a squeeze right now,” Mark Langston, Compass Surgical Partners’ chief development officer, told Becker’s. “If you have an independent surgery center, it’s tough. If you’re in an independent practice, also tough. If you’re doing both — good luck in today’s world — that’s really, really hard.”
Compass, which has developed more than 250 ASCs in the past 30 years, works to align physicians and ASCs with health systems. The goal is to preserve clinical independence while giving providers the scale and contracting power they need to compete.
At the heart of Compass’s approach is a three-way joint venture model, Mr. Langston told Becker’s. The company pairs health systems and physicians in structures tailored to each market.
“Health systems are the hand. Our job is to cut the glove that fits the hand,” Mr. Langston said. “We work hard to understand the system’s strategy and where we can add value — sometimes doing things differently because we see best practices across the country.”
That customization, he added, is what differentiates Compass’ partnerships.
Recent examples highlight the strategy. In March, Compass joined with the Orthopaedic Institute of North Texas of Frisco, and Lam Vascular & Associates in Dallas to open a new ASC in Frisco, Texas. The company also works with Cincinnati-based Bon Secours Mercy Health, a partnership that has already launched four joint venture ASCs since 2023, with plans to develop 30 more across multiple states.
Agility is another cornerstone of Compass’ model. Mr. Langston said the leadership team avoids over-engineered solutions, focusing instead on speed and simplicity in deal execution.
“Once you have the structure, being nimble on decision-making allows Compass to work with a system to create speed to strategic execution,” Mr. Langston said. “Marrying our processes with a system for deal review and approvals, removing barriers, is paramount.”
This balance of structure and flexibility, he noted, has been refined over decades and is central to Compass’ success.
Looking ahead, Compass sees opportunity in both scale and specialization. Metro-area density is still a priority, but specialty-driven growth may accelerate the most. Cardiovascular, gastroenterology, ophthalmology and orthopedics are top of mind.
Compass has multiple cardiovascular ASCs under development and expects rapid growth as CMS expands the ASC-covered procedure list.
“The proposed rule removing limits on Medicare’s ASC procedure list will bring 500 more musculoskeletal codes alone,” Mr. Langston said. “That’s a huge growth potential.”
Still, Compass avoids what Mr. Langston calls “dots on a map” expansion. Instead, the company prioritizes partnerships within defined geographies, ensuring all stakeholders share a common vision.
“Without intentionality, scattershot growth doesn’t work,” he said. “That leads to divided loyalties and discord. The opposite is intentionality: a clear strategy that brings value to everyone. That’s where the magic happens.”
