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PRACTICE
MANAGEMENT
Orthopedic practices trending toward
independent supergroups
By Alan Condon
I
ndependent orthopedic practices are
weighing partnerships that will pro-
vide a launch pad for future growth as
increasing administrative and economic
hurdles continue to plague small to midsize
physician groups.
The orthopedic landscape is changing,
with physician-owned practices increas-
ingly trending toward large "supergroups"
with wider networks of physicians,
practice locations and ancillary services.
For many smaller practices, this option
presents the best path to remain competi-
tive and independent.
Four such groups with 100 physicians or
more were formed in Texas, Florida, Tennes-
see and New Jersey in the last two years.
Most recently, three orthopedic practices in
California merged to create Golden State Or-
thopedics & Spine, the third-largest specialty
group in the western U.S. With 60 physicians
and 19 locations, Golden State began opera-
tions Jan. 1 and is looking for opportunities
to bring more practices and physicians into
the fold.
Supergroups are becoming an increasingly
attractive option for smaller practices. The
integration of many practices into a single
entity can provide significant advantages
when it comes to combining resources,
leveraging payer contracts, decreasing
costs and accessing economies of scale. In
this way, supergroups can shield them-
selves from reimbursement reductions and
address patient concerns about the rising
cost of care.
"Many of the supergroups that have formed
understand the leverage that exists when it
comes to referrals and contracting with insur-
ances and payers. With such a large network
of physicians and facilities, they are better able
to control access, cost, quality and outcomes,"
Tim Ekpo, DO, an orthopedic surgeon at
Henry Ford Health System in Detroit, told
Becker's. "I believe over the next few years, the
positive economics of being part of a super-
group will become more apparent, and we will
see continued trends in their formation as we
deviate from the smaller group practices."
At a time when big hospitals and practices
control regional markets, supergroups offer a
strategic advantage, enabling more modestly
sized practices to maintain independence
and position themselves for growth.
Tampa-based Florida Orthopaedic Institute
became the largest independent orthopedic
practice in the state and the 12th largest in
the U.S. aer merging with MD Healthcare
Partners in 2019. Since the merger, the su-
pergroup more than doubled its revenue and
number of physicians.
ough the benefits of a supergroup can
be enticing, there are some drawbacks.
Establishing these entities can be costly and
complex. As with all large organizations, the
bigger they are, the more challenging they
can be to govern.
"Smaller groups who are feeling these pres-
sures must ask themselves where they want
to be in three to five years, what strategy will
best get them there, and who might be the
best partner to most predictably execute on
such a strategy," David Jacofsky, MD, CEO of
e CORE Institute in Phoenix, told Becker's.
"One issue with consolidation is that studies
have shown that without existing infrastruc-
ture, costs can actually increase rather than
decrease with size, and payers no longer
respond well to scale alone when groups
try to leverage fee-for-service rate increases
without objective claims data that proves a
return on investment for the payer."
In any case, the starting block for practices
considering forming a supergroup should
be the alignment of cultures and practice
values, according to Nader Samii, CEO of
National Medical Billing Services. He said
the success of such groups is built on the
following foundations: financial integration,
clinical integration, managed care contract-
ing, IT, revenue cycle, costs, marketing, legal
and corporate structure. n
Rothman Orthopaedics Florida to
add physicians, locations in 2022
By Alan Condon
P
hiladelphia-based Rothman Orthopaedic Institute is scaling up in
Florida this year, with plans to recruit more physicians and add offices,
according to the Orlando Business Journal.
The orthopedic group partnered with Altamonte Springs, Fla.-based Ad-
ventHealth to expand into Central Florida and spent the last year growing
the number of physicians in the region and establishing offices. Rothman is
leasing a space in AdventHealth's $100 million, 12-story Innovation Tower,
which is expected to open later this year.
The practice aims to have eight offices in Florida by the end of 2022, with
additional locations set for 2023, Daryl Osbahr, MD, chief of orthopedic
surgery at Rothman Orthopaedics Florida and executive medical director of
AdventHealth Orthopedic Institute, told the Journal.
The group currently has five offices in Florida and offers surgery at six Ad-
ventHealth hospitals or surgical pavilions.
Rothman also plans to bring on 30-35 physicians by the end of 2022 and 50
physicians in five years and estimates it will see about 40,000 patients in
Florida this year, according to the report. n
