Surgery volume booms after surgeons leave hospital to open private practice, ASC

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Joseph Greene, MD, and Jonathan Yerasimides, MD, are exceeding expected surgery volume after leaving hospital employment to establish the Louisville (Ken.) Hip & Knee Institute and build an ASC.

The two surgeons, who both specialize in hip and knee arthroplasty, founded the institute in January. Their multimillion-dollar ASC, the Jeffersonville, Ind.-based Landmark Surgical Suites, also recently opened.

While financial viability was considered in their decision to open the facility, Dr. Greene told Becker's that the transition primarily was spurred by wanting to control the patient pathway. 

"I struggled within a large bureaucratic system whenever I wanted to make dynamic changes," he said. "With a large corporation, it's very hard to control that and to make modifications where we wanted to."

This decision also was motivated by hip and knee procedures being some of the highest-earning procedures in the ASC setting. 

The two had built up a large referral network so they didn't need to rely on hospital networks — Dr. Yerasimides has been in practice for around 15 years and Dr. Greene for almost 10 years. 

"We don't necessarily have a system-based referral pattern, and so that's why we felt comfortable leaving a larger system," Dr. Greene said. 

After encountering initial obstacles securing loans amid the COVID-19 pandemic, business has taken off. 

"Volume is exceeding what we thought it would be at this time," Dr. Yerasimides said.

This caseload increase was aided by CMS removing hips from the inpatient-only list. Dr. Yerasimides said he expects this decision to further increase volume. 

"That is a giant windfall," he said. "Now that it's off the inpatient-only list, that's just going to make volume explode, because you'll be able to do essentially everyone through your ASC and not just selected private payers."

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