Elevate ENT Partners CEO on PE investment in ENT & forming an MSO

Elevate ENT Partners president and CEO James Polfreman spoke with Becker's ASC Review about private equity investment in the ENT space and the formation of management services organization, Elevate ENT Partners.

Note: Responses were edited for style and clarity.

Question: How did Elevate ENT Partners come together?

James Polfreman: The first portfolio company that we acquired was South Florida ENT Associates in Miami Lakes, Fla. Since then we've partnered with the Barranco Clinic in Winterhaven, Fla. and Texas ENT Specialists, in Houston, Texas.

The management services we were providing to South Florida ENT Associates were always there, but now we are providing them to all our portfolio ENT practices and we decided to brand the MSO as Elevate ENT Partners.

Q: What made you decide to formalize and brand services now?

JP: We've doubled in size since September 2020, so there wasn't anything that precipitated it. That was always the plan, and it was the right time for us to formally launch Elevate ENT Partners.

To take a step back, this company is a portfolio company of the Audax Group. The Audax Group has successfully completed many physician roll-ups in other areas, such as gastroenterology, dermatology, urology, women’s imaging etc. Typically the way it's structured is that there's an MSO under which you have all the different partnerships and physician groups. With me coming on in September last year and adding five members to the executive team, we now have an extremely competent MSO team to brand and take to market.

Q: What are some of your goals for this year? Are there any plans to add new affiliations in the near future?

JP: We will continue to expand rapidly, and we have a number of partnerships in progress.

We're also going back and reevaluating all the technology that we have and trying to figure out how to further enhance our MSO platform such that all physicians in our MSO will really reap the advantages of scale and benefit from all our expert leadership in back-office functions such as managed care contracting, finance, HR, purchasing, billing etc.

We want to remove all the stress that ENT physicians have outside of being able to see patients and practice medicine. Managed care contracting, human resources, compliance, finances and billing and collections are necessary and have to be done well, but that’s not why most physicians chose to go into medicine. So we're providing all these services to allow physicians to focus on what they love, treating patients.

Q: What advice do you have for private practices considering affiliation or consolidation?

JP: It's not for everyone, but I feel that many physicians and practices can benefit from what we can provide if they are looking to reduce their administration costs and focus more on growing their practices. I'm particularly concerned for smaller groups with two to six physicians who have to perform all these back office functions, in addition to treating patients. Their costs have to be high and could be both reduced and functions improved with our model.

I don't know when the physicians find time to do everything in addition to practicing medicine. In reality, what happens is they practice medicine Monday to Friday and then they have to do all the administrative tasks after-hours. It's something that physicians should be thinking through from both a business and quality of life perspective.

Q: Can you speak to PE investment in the ENT space and if you anticipate growth in that area?

JP: There's been a lot of successful private equity investments in other sub-specializations. The Audax Group has completed a number of deals with different physician subspecialist groups.

As it relates to the ENT space, private equity investment is in its early stages. We're one of the first ENT MSO groups to go to market with this concept. In the next three to five years, I predict more private equity groups will enter the ENT space because they'll see the success that we're having.

Q: Is there anything else you'd like to touch on that I didn't ask about earlier?

JP: I think there's an opportunity here to really help physicians figure out how to engage directly with patients. Traditionally, people would go to a primary care physician and the primary physician would refer them to a specialist. I think now people want to go directly to the subspecialist. So something that we're really looking at is how to engage patients directly.

Q: Is that a challenge physicians have come to your group looking to solve?

JP: Yes. Physicians want to grow their practices, and we want them to accomplish that desire. I think more patients want to go online to do their research to find a good ENT practice. So that's something we're focusing on for our current practices, especially after the negative effects of COVID-19 on patient growth.

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