Becker's Spine Review

30 PRACTICE MANAGEMENT 6 keys to orthopedic success in the next 2 years By Patsy Newitt T he pandemic has shied the ortho- pedic industry tremendously. Six or- thopedic leaders share their solutions to ensure orthopedic success in the coming years: 1. Shift to ASCs " A private practice will have a hard time maintaining autonomy without an ASC, as increased regulatory burden and decreased reimbursement have led to high overhead models for most groups," said Nitin Khanna, MD, spine surgeon and founder of Munster, Ind.-based Spine Care Specialists. Dr. Khanna added that ASCs give surgeons more control of the work environment — making them more efficient and increasing job satisfaction. "With case migration to the outpatient set- ting, a well-run ASC should be profitable for the foreseeable future," said Ed Hellman, MD, president of Indianapolis-based OrthoIndy. Orthopedic surgeon Nicholas Frisch, MD, president of operations for Birmingham, Mich.-based Smithfield Surgical Partners, added that this migration is specifically im- portant for surgeons performing joint re- placements because of CMS adding total joint procedures to its outpatient list. 2. Implement virtual tools Implementing virtual patient management tools and telehealth platforms can help ortho- pedic practices stay ahead of industry changes. "ese can affect not only workflow of the practice operations, but the culture of the organization and how you interact with your patients," Dr. Frisch said. "Implementing the infrastructure needed to manage patients more remotely is critical." is inclusion will also help patients locate and choose these practices. "Most patients research orthopedic practic- es and providers online — most of the time on their phone. Making sure your practice has an up-to-date web presence can decide whether or not you are even in the running to be their surgeon," said Jeffrey Hodrick, MD, orthopedic surgeon at Nashville, Tenn.- based Southern Joint Replacement Institute. 3. Focus on industry shifts Understanding the industry is critical for ortho- pedic practices to stay ahead of market shis. Michael Ast, MD, an assistant professor of orthopedic surgery at Weill Cornell Medical College and surgeon at Hospital for Special Surgery, both in New York City, said an in- dustry understanding is critical for success. "It is important for practices to understand the landscape around them and position them- selves to be nimble if major market shis occur locally," he told Becker's. "Failure to recognize the landscape as a whole would be a major risk to an orthopedic practice." 4. Diversify revenue Andrew Bush, MD, is an independent ortho- pedic surgeon at his solo practice, Central Carolina Orthopaedics Associates in Pitts- boro, N.C. He told Becker's that he has had to revamp his practice by gaining a pharmacy dispensing license and starting a regenerative medicine program. "It seems that the diversification of reve- nue-generating activities is the only way a small practice like mine will hopefully sur- vive the current trends in medicine," he said. "I think the key to maintaining a positive cash flow is a diversified ancillary income stream," Dr. Hellman said. "Advanced imaging, thera- py and [durable medical equipment] should all figure into the ancillary stream." 4. Use robotic assistance Some surgeons say robotic assistance in the op- erating room, especially in joint replacement, will continue to grow in the coming years. "Although we must be good servants and measure our results of this technology, it is my opinion that we will be able to provide a better, more standardized surgical prod- uct by using a robot," Dr. Hodrick said. "As our experience deepens and results are pub- lished, patients will seek the best care and lat- est technology." 4. Consolidate with larger companies Four orthopedic supergroups of 100-plus physicians have formed since the onset of the pandemic. Some orthopedic surgeons predict consolidation will continue as payers see op- portunity for ownership in surgery centers. Hussein Elkousy, MD, an orthopedic sur- geon at Houston-based Fondren Orthopedic Group, told Becker's that consolidating into large group practices will "improve quality and improve efficiency and focus on ancillary revenue stream." n Florida orthopedic group breaks ground on 2nd facility in 2 months — 4 details By Alan Condon C oastal Orthopedics broke ground on a facility in Bradenton, Fla., two months after it began work on an 88,000-square-foot headquarters in Lakewood Ranch, Fla., Sarasota Magazine reported May 19. Four details: 1. The 34,000-square-foot Bradenton facility will include physician offices, flu- oroscopy suites, MRI and a physical therapy gym. It is expected to open in spring 2022. 2. On March 9, Coastal Orthopedics broke ground on its Lakewood Ranch headquarters, which will feature an ASC with six operating rooms, clinical ser- vices, physical therapy, administrative offices and imaging. 3. Coastal Orthopedics plans to hire about 150 to 200 employees for the headquarters, which is slated to open in April 2022. 4. The practice currently has 20 physicians and five locations, including two ASCs, according to its website. n

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