Becker's ASC Review

69 ORTHOPEDICS Smart ideas in spine: 4 surgeons look to the future By Laura Dyrda Spine and neurosurgeons across the U.S. are facing different realities than they were a year ago due to the pandemic. Here are key thoughts from four spine surgeons about how they're thinking about their practice going forward. Question: How would a second shut down in your state affect your practice? Khawar Siddique, MD. DOCS Spine + Orthopedics (Los Angeles): It seems a second shutdown is only a matter of time. Even though we're an essential business, many procedures end up being deferred until the govern- ment gives us approval. Elective surgeries are the lifeline for any surgical practice. Not just from a payment perspective, but from a momentum stand- point. We gain momentum by word-of-mouth and when we're shut down, in any capacity, that organic word-of-mouth-marketing decreases significantly. It's almost like starting a new practice each time we re-open. Q: What percentage of patient volume is your practice current- ly operating at? What was the key to your ramp-up strategy? James Chappuis, MD. SpineCenterAtlanta: [As of July 21] we were operat- ing at 75 percent to 80 percent capacity in most departments. Our physical therapy department may see lower numbers, due to the closeness of the personal space required for those types of appointments. e key for us as a practice has been the flexibility with patient schedules. Q: What strategies is your practice implementing to improve its financial standing? Mark Tantorski, DO. Premier Orthopaedics (West Chester, Pa.): As with most businesses, our company was not immune to the negative financial impact of the pandemic. A small number of staff were furloughed and some had hours decreased, but we are currently back to full complement. As we trend toward normalcy, we have continued to implement safety strategies that, combined with rigorous screening and disinfecting protocols, have allowed us to significantly increase the numbers of individuals we see in the office while providing the patient a sense of security. We have received posi- tive feedback from patients regarding these measures. Q: Where do you see the biggest opportunities for spine sur- geons on the current landscape? James Lynch, MD. SpineNevada (Reno): We have to prepare for the future now. I think building a musculoskeletal differentiated practice with the whole spectrum of patient care is important. I think the isolated silos of practice — whether it's surgery, pain management or PM&R — working individually is going to change, except if you're in remote areas. ere's a rapid transforma- tion occurring. at may not be in months, but certainly over the next three to five years. I think focusing on partnerships or investments in an ASC platform is a natural transition for this. Currently, about 10 percent to 15 percent of spine cases are being done in an ASC platform, which is far too low. Some projections have this at 35 percent to 40 percent over the next few years. n Medtronic to buy Medicrea for 22% above share price: 6 details By Laura Dyrda M edtronic entered into an agreement to acquire Medicrea, a spine device company that includes artificial intelligence, predictive modeling and patient- specific implant offerings. Six things to know: 1. The two companies signed a tender offer agreement for Medtronic to acquire Medicrea's outstanding shares in a friendly voluntary all-cash tender offer for around $8 per share. 2. Both companies' boards of directors ap- proved the transaction. 3. The offer of $8.01 per share is 22 percent more than the closing price of Medicrea shares on July 14 and 33 percent over the one-month volume weighted average price of Medicrea shares. The offer is 56 percent of the three-month volume-weighted average price of Medicrea shares. 4. Medtronic aims to grow its presence in the enabling technologies and spine markets. The company already has a portfolio of spinal implants, robotic and navigation technology as well as 3D imaging solutions. Medicrea's data analytics, artificial intelligence and personalized implants will integrate with Medtronic's procedural solutions. 5. The transaction is expected to close by the end of 2020 and be immaterial to Medtronic's adjusted earnings per share for the first two fiscal years after the acquisition. 6. BofA Securities and Societe Generale are the financial advisers for Medtronic, and DLA Piper is the company's legal adviser. Medi- crea's acting financial adviser is Cowen, and its legal adviser is Baker McKenzie. n

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