What it takes for ASCs to win over new spine surgeon investors

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As more spine procedures migrate to the outpatient setting, some spine surgeons will consider investing in ASCs. Although a daunting idea for surgeons, there are factors ASCs can focus on to draw the eyes of spine surgeons.

"From a clinical standpoint, the center must be capable of handling spinal procedures in a safe and efficient manner," said Todd Lansford, MD, of Charleston-based South Carolina Sports Medicine & Orthopaedic Center. "If the center does not feel comfortable, or does not have the proper setup, then there is no use going forward. Many centers may be able to handle these cases, but have not done so yet. This requires significant patience and time, but can be a great opportunity to boost a center."

There are also advantages and disadvantages with ASCs that are established in spine surgery versus those still building programs, Dr. Lansford said.

"An ASC that is new to spine surgery can have a financial upside that may be higher," he said. "By bringing value to a center, you can take what could be lower share prices and have a greater return … A center that is already established with spine surgery will likely have a higher share price but will already be showing good returns. The contributions can still be felt, without the concern for feeling overwhelmed by being such a majority contributor."

Usman Zahir, MD, of Dulles, Va.-based ScopeSpine-The Orthopedic Group, echoed that, saying surgeons should consider the costs and time that may come with investing in an ASC.

"Established ASCs have costly share prices and often few shares that are available, but they usually have a more predictable return than a pure start up," he said. "A startup ASC with low or nominal share prices may take years to be successful."

He also said investors should pay attention to an ASC's partnerships.

"Established ASCs that have many passive physicians are a red flag," he said "For startups, it is important to get a sense of what the true case volume is first, before committing. Many ASCs start with attractive pro forma statements, but if the surgeon partners are involved in too many ASCs, it might be best to move on."

ASC investment is like any other business investment, Dr. Lansford said.

"The risks come with a reward," he said. "The only important factor is that the patients are never at risk. Therefore, clinical safety and appropriateness are the No. 1 priority."

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