New York City-based Sapient Health is one of them. Joseph Romano and Bill Ingram, co-owners of Sapient, joined Becker’s to discuss what sets their company apart and how it supports ASCs.
The two first met while working at Frontier Health, which was sold to Physicians Endoscopy in 2017. There, they gained firsthand experience with ASCs, ranging from those that thrived long term to those that closed after ownership transitions.
Sapient Health has evolved in two phases: Mr. Romano originally founded it in 2014 after leading Frontier Health, focusing on ASC turnarounds. Then, in 2022, he and Mr. Ingram relaunched the company to focus on physician-driven models and local expertise.
Mr. Romano, a former leader at ASC giant United Surgical Partners International, describes Sapient as having “the expertise of a large management company while maintaining a personalized, startup-like feel.” Unlike national firms, Sapient emphasizes regional representation, particularly in New York, New Jersey and Florida.
A key differentiator is Sapient’s physician-driven model. The firm enters deals as a minority partner, ensuring physicians retain leadership while gaining business acumen for long-term success.
“It’s crucial for physicians to lead their centers, but they also need to understand business operations to ensure longevity,” Mr. Romano said. “Beyond the first 15 to 20 years, ASCs need a long-term strategy, not just a liquidity event with private equity. Helping physicians build sustainable ASCs is critical.”
Sapient Health also helps address key challenges in the ASC space, including the high cost of entry for new physicians and the hesitancy of founders to offer meaningful ownership stakes.
“We help physicians understand that a well-utilized, multi-provider center is more profitable in the long run, even if each physician holds a smaller share of a larger operation,” Mr. Romano said. “Aligning incentives is key — ensuring every physician involved feels vested, rather than frustrated by being shut out by original owners or a corporate firm with majority control but minimal contribution.”
New York exemplifies the challenges of regional consolidation. Despite being a large state, it has fewer than 200 ASCs. Demand is high, and the Department of Health is open to approving new centers, yet regional competition remains limited, Mr. Romano told Becker’s.
“Developing ASCs is tough work,” Mr. Romano said. “Larger companies often rely on smaller firms like ours to do the groundwork — only to acquire them later.”