Becker's ASC Review

10 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Business of Spine - call (800) 417-2035 around an existing ASC," says Mr. Péo. "From the outside, a market might look great and then we go in and there are challenges that shut down our plans. Or we might see a market that looks chal- lenging but once we go in there's a good opportu- nity for us. It really boils down to case volume and what the payers are willing to pay." Turnaround opportunities ASC success depends on attracting case volume and new physician investors. People are now reaching out to independent physicians more regularly and offering investment opportunities more quickly than in the past, says Mr. Péo. "It's amazing how many independent physicians are available that aren't ASC owners already. In most cases, you may have to turn over a few leaves to find them," says Mr. Péo. "The medical staff at your ASC can ask around among their colleagues about physicians who might be interested. It can't just be up to the development company and ad- ministrator to get those cases; the physicians have to be intimately involved." Orthopedic and spine surgeons are among the largest group of specialty physicians indepen- dent of hospitals. "Orthopedics and spine are still great for surgery centers," says Mr. Péo. "You can also approach neurosurgeons, especially the younger surgeons, about doing cases at the center. The older neurosurgeons aren't used to doing cases at the ASC and might say they can bring volume, but when push comes to shove they often aren't comfortable with it. The young- er surgeons were trained in these techniques and more comfortable with doing these procedures in an outpatient setting." ASC owners may also consider taking on a corpo- rate partner. ASCs typically seek corporate part- ners for one of three situations: 1. The ASC needs an injection of capital to keep their doors open. "This is happening to ASCs around the country," says Mr. Péo. "They lose surgeons, sign bad contracts, see rent go up or have trouble keeping up with their debt pay- ments. The owners are not doing well and need someone to give them a jolt to survive." 2. The ASC is doing well, but foresees is- sues in the future. "They see the writing on the wall and hospitals are coming in to talk to their surgeons about employment," says Mr. Péo. "Or the hospital is employing primary care physi- cians so referral patterns are changing. They are looking to partner with an ASC company and/ or joint venture with a hospital. Oftentimes, the surgery center would like an ASC management company to act as a buffer between the ASC and the hospital." 3. The ASC is running fantastically and physician owners are looking for an eq- ASC Growth & Evolution in the New Healthcare Environment (continued from cover) Jeff Péo

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