'Antidote to private equity': Some ASCs choose affiliation over acquisitions

As private equity firms continue to enter the ASC market, some ASC leaders have found alternatives through affiliations with other practices. 

John Prunskis, MD, is an interventional pain specialist and the CMO of DxTx Pain and Spine, a network of affiliate interventional pain and spine practices. 

Dr. Prunskis spoke to Becker's ASC Review about his solution to the troubles of private equity investment. 

Question: Is private equity investment good or bad for ASCs? Why?

John Prunskis: It could be good, it could be bad. My experiences mainly with private equity as it pertains to ASCs are those affiliated with pain and spine practices. Having the longest established and largest private interventional pain practice in the Chicago area, we've been approached by private equity groups, but we chose not to affiliate with any of them and instead started DxTx Pain and Spine.

Most private equity [firms] operate with a cookie-cutter approach — there's money upfront, but then you really have to adapt to their system. You're referred to as an acquisition. Many physicians who have ASCs in the pain and spine space have worked very hard to establish their reputations and their clinical outcomes — being put into a strict structure that has worked perhaps in other healthcare markets, may not resonate well. 

This led to the formation of DxTx Pain and Spine, which is a consortium of affiliated pain practices. We have expanded locations in six, soon to be seven, states over the course of a year and a half. We call ourselves the "antidote to private equity," where, yes there is some money upfront, but then we emphasize physician autonomy and recognition for what it took for that practice to get to where it is today. 

We specifically monitor opioid narcotic prescribing and billing compliance. Beyond that, we're only affiliating with practices that are already clinically excellent. The individual practitioners can choose how they might want to improve their own patient care and outcomes by observing what other practices in the consortium are doing to improve their practice.

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