Becker's ASC Review

24 ORTHOPEDICS What differentiates 1 orthopedic MSO from other private equity-backed groups By Carly Behm U nited Musculoskeletal Partners has taken a different approach to private equity, something that has been widely debated among independent orthopedic surgeons and groups. UMP formed in 2021, and has grown significantly. CEO Alex Bateman discussed how private equity benefitted the MSO. Note: Responses were lightly edited for style. Question: Private equity has been polarizing among some orthopedic surgeons. How has UMP and its practices benefitted from private equity from a physician and leadership perspective? Alex Bateman: For us it is important that we differentiate the UMP model from other PE-backed models. UMP has capital partners that invested in the MSO based on our early successes and growth trajectory. We then invested that capital into high-performing practices in Georgia, Texas and Colorado and helped support them with additional resources, infrastructure and strategy. Two-and-a-half years into UMP's development, we remain steadfast in our commitment to high-quality patient care being delivered at the local level and the continuance of private physician practice. It is also important to note that declining reimbursements, increasing overhead and administrative burden are oen the primary drivers for many musculoskeletal groups to enter the PE model. Consequently, many independent practices have sought the PE-backed model Vendor consolidation will occur and hospital systems will more and more limit access to vendors to reduce cost. All this will reduce surgeon autonomy. Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Healthcare economics and its direction will factorially depend on political lean, as the costs to the insured escalate, demand/expectations continue to rise, and specialty care becomes scarcer. Proclamation of dissolving private insurance and 'Medicare for all' decrees will surely bury an already overburdened system. Elections do have consequences. e scale of practice management and overhead, especially in this area, has led to the closure of private surgical facilities and bankruptcy of previously formidable medical groups. Upgrades of EHR alone and other technology are staggering and prohibitive. Being an independent practitioner carries great financial risk and is not the choosing of the timid. Best practices for the complex spinal surgeon and meeting the needs of the OR and its expenditures remain employment models and ventures with larger institutions. n 2 Hospital for Special Surgery leaders on the most 'exciting and opportune' area of spine By Carly Behm B iologics holds numerous possibilities for the future of spine surgery, and leaders with New York City- based Hospital for Special Surgery are exploring ways it can be leveraged. Andrew Sama, MD, co-chief of HSS Spine, and Sheeraz Qureshi, MD, MBA, co-chief of HSS Spine and chief medical officer of HSS Florida, discussed their outlook on biologics in the specialty. Note: This conversation was lightly edited for clarity. Question: Where do you see spine biologics growing in five to 10 years? Dr. Andrew Sama: Biologics is the most exciting and most opportune area in spine surgery. We have an understanding of the metal and the mechanics of how we operate on the spine, and we can certainly improve on that. But from a societal standpoint, it would be much more powerful if there was a way to understand the underlying biological reasons for some of the things we treat, and then figuring out a way to intervene before they become mechanical issues that require decompression or fusion instrumentation. I think that's the future. With artificial intelligence and some of the other modes we have of understanding these processes on a larger scale, I think we can make some meaningful assessments and then act on those things in a more accurate and successful way. Dr. Sheeraz Qureshi: I think about biologics in two big buckets. I think about the biologics that we use for fusion which we're using every day. There is a huge opportunity there because they're often significant cost drivers to care. One of the things we've been doing in our service is trying to better define how much biologics something like infusion we should be using for particular types of surgeries. Then there's the other aspect of biologics around stem cells and things like that that are really hot topics for patients. But we don't have a significant understanding of where the value is in those. One of the things that our service has been doing is working through the regenerative medicine program that's led by Scott Rodeo, MD. Our spine service has involvement in trying to really develop protocols and understand better what the value is of those types of biological treatments. n

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