Becker's ASC Review

14 ASC MANAGEMENT The rise of the three-way JV in ASC development By Patsy Newitt A s pressures mount on independent physicians and health systems, a new model is reshaping ASC development: the three-way joint venture. is structure, typically uniting a health system, a physician group, and an ASC management company, aligns interests across care while preserving physician independence. Mark Langston, chief operating officer at Compass Surgical Partners, told Becker's these ventures have become central to the company's growth and a lifeline for practices facing consolidation. In 2024, 42.2% of physicians were working in private practice, a significant drop from 60.1% in 2012, according to a survey from the American Medical Association. Conversely, the share of physicians working in hospital-owned practices rose to 34.5% in 2024, an 11 percentage point increase from 23.4% in 2012. Mr. Langston frames three-way JVs as a direct response to the "squeeze" on independent physicians and ASCs. He said small practices struggle in risk-based models, lack payer leverage and oen can't afford needed infrastructure. "Independent physicians are really in a squeeze right now," he said. "If you have an independent surgery center, it's tough. If you're in an independent practice, also tough. If you're doing both—good luck in today's world." ree-way JVs pool resources while maintaining physician equity and autonomy. Compass focuses on aligning incentives, embedding with health systems to build local strategies, reduce administrative burdens, optimize anesthesia coverage and recruit staff. "For the ASC, we focus on the imperatives in today's environment: how do we work within a three-way joint venture to bring you a connected strategy in a metropolitan area?" Mr. Langston said. "How do we create opportunities to coordinate care between primary care physicians and specialists who are ASC partners to deliver the highest quality of care?" By partnering with management companies and physician groups, health systems can expand their ASC footprint faster, without shouldering the full capital and operational burden. However, Mr. Langston warns that three-way JVs only work when all partners are fully committed to a shared strategy. "One of the biggest red flags is health systems who see viability as 'a foot in two canoes'—wanting a great ASC strategy but not fully committing to the strategy for various reasons," he said. He noted green flags include managed care readiness, engaged physicians and unified leadership. "Time kills deals," Mr. Langston added. "Clear decision-makers are critical. Without them, deals lose momentum and die." Ultimately, Mr. Langston sees three-way JVs as a way to protect physician independence while providing the scale and structure payers and health systems demand. "We want both the practice and the ASC to be positioned for long- term, durable growth and success … while allowing the physicians to maintain their clinical independence," he said. n Surgery Partners executive to resign By Patsy Newitt B rentwood, Tenn.-based Surgery Partners announced that Harrison Bane, national group president, will resign Oct. 3, according to SEC documents accessed by Becker's. Mr. Bane notified the Board of Directors of his decision Sept. 11. According to the statement, the resignation is not related to any disagreement with Surgery Partners regarding operations, policies or practices. On June 17, Surgery Partners, one of the country's largest ASC operators, rejected a buyout bid from Bain Capital, its largest shareholder, choosing to remain independent. n SSM Health cuts ribbon on outpatient center By Cameron Cortigiano St. Louis-based SSM Health is set to open a new outpatient campus in Sun Prairie, Wis. The 90,000-square-foot facility aims to expand access to eye care through outpatient eye and orthopedic surgical services, according to a Sept. 17 news release shared with Becker's. In addition, the campus has an onsite pharmacy, optical laboratory, retail optical and laboratory services. The center will open to the public Sept. 22, the release said. n

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