Becker's ASC Review

12 EXECUTIVE BRIEFING 2 EXECUTIVE BRIEFING SPONSORED BY The importance of multi-level partnerships for new- build ASCs — Insights from Forté Sports Medicine and Orthopedics O perating an ASC in partnership with a health system and a medical device manufacturer is not for the faint of heart. With outpatient surgeries and ASC utilization continuously growing, there are clear opportunities for innovative, focused ASCs — but there are also distinct challenges. Becker's ASC Review recently spoke with Marty Rosenberg, CEO of Forté Sports Medicine and Orthopedics, a five-location orthopedic group with ASCs in Indianapolis that built out a new orthopedic hospital and outpatient center at the height of the pandemic. Mr. Rosenberg reflected on the strategic decisions the group made, the unique benefits of setting up the center in dual partnership with a large health system and with a vendor that brings a full spectrum of products and support services to the table, and key business and operational aspects that ASC leaders need to consider when eyeing such partnerships. The ASCs of today and tomorrow are not the ASCs of yesteryear In recent years, the dynamics of designing, operating and managing orthopedic ASCs have changed. These changes have been prompted mostly by the growing acuity of patients that opt to be treated at ASCs, since joint and spine surgeries require the installation of larger, more advanced pieces of imaging and operating room equipment than ASCs have traditionally used. "The ASCs of today require bigger footprints," Mr. Rosenberg said, adding that in the pivot from inpatient to outpatient surgery, surgical center operators also must plan for longer recovery and observation times for patients to ensure safe discharges. Another trend in the ASC space is branching out into the growing market for relatively fast surgeries, such as carpal tunnel releases, which typically only last around 20 minutes and are less equipment intensive. But, to improve overall efficiency for the facility, those interventions may require the addition of smaller ORs. "If you're going to build a new ASC, you need to take that into consideration," Mr. Rosenberg said. "And if you're going to retrofit your current ASC, there are some unique challenges because it's hard to change the footprint." Mr. Rosenberg highlighted that, for them, partnering with a health system to build their ASC within an orthopedic specialty hospital that also allows for inpatient care, they had to be set up, equipped and staffed in resemblance to, and in compliance with the strict regulatory environment of a hospital – a trade off they were willing to make for the expanded capabilities and access. Partnering with a health system can give new ASC operators a competitive advantage As ASCs take on more outpatient cases and engage in more clinically complex care, partnering with a health system can be a way to address some of the associated challenges. This is the path that Forté's management chose after it started building a 250,000-square foot orthopedic hospital and outpatient center just as the COVID-19 pandemic hit, supply chain challenges followed and the complexity of operating in the para- pandemic environment became even more evident. "Health systems have the talent and pool of individuals who are familiar with that clinical complexity," Mr. Rosenberg recalled. "So being able to tap into the knowledge and expertise of a health system on some of

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