5 Key Strategies for National Expansion of Orthopedic and Spine Practices

Practice Management

Since opening its doors in Tampa, Fla., in 2005, Laser Spine Institute has expanded the Tampa location twice and built two new facilities, one in Scottsdale, Ariz., and one in King of Prussia, Pa. Jimmy St. Louis, Chief Corporate Operations Officer of Laser Spine Institute, says the practice's success can be partially attributed to patient satisfaction with the minimally invasive techniques used by LSI physicians and the marketing techniques the practice employs to aggressively expand its reach.

In the future, Mr. St. Louis says LSI may consider expanding internationally to treat medical tourism patients around the world. However, the company's executives and administrators are currently focused on further expanding the LSI's presence across the country. Mr. St. Louis discusses the growth model of LSI and offers five tips for national expansion of orthopedic practices.

1. New Market Test Process.
The first step practice administrators should take when considering whether to expand into a new location is to determine if the market can support a new facility. Laser Spine Institute administrators examine different locations and rate them on a score cards based on population, competition, cost to do business and current market performance. When the top cities are selected, the administrators and physicians conduct patient seminars in those cities to assess patient interest and further gauge the potential market. During the seminars, LSI physicians present about minimally invasive spine surgery procedures and offer free MRI readings to the audience. "It's an involved process," says Mr. St. Louis. "Typically, it's an eight-month process but it has worked well." The entire process is eight months from the time LSI opens the consult office to the time the company opens a surgery center.

When the seminars go well, LSI will consider opening a small practice to see prospective patients, at which time the company will assess the market for a new surgery center as well.

2. Educate the payors about the procedures.
LSI works most often with out-of-network payors, so the administrators often speak with payors about why they should cover a patient's procedure. Mr. St. Louis makes sure to point out that patients undergoing minimally invasive surgery have less conservative care before choosing surgical treatment, that the surgery is done as an outpatient procedure and that the recovery rate is faster. All of these factors contribute to a lower cost for payors and a higher rate of patient efficacy, which is another important point to cover with the payors.

"When we educate payors and patients on the reimbursement level, we anticipate we’ll see improved reimbursement because it is less money than what they would pay for the traditional surgery," says Mr. St. Louis.

3. Pursue in-network contracts.
LSI has traditionally gone directly to the customer and contracted with their providers out-of-network. However, the practice has recently been creating in-network contracts with payors, partially because payors are pursuing contracts with them. Mr. St. Louis says whenever he goes into in-network contract negotiations, he will make sure the in network rate is comparable to their recent collections history. He says administrators should have practice data (such as outcomes and patient volume) available during the negotiations to convince payors that the practice and physicians provide the optimum care.

LSI has begun generating whitepapers and participating in retrospective and perspective studies showing the effectiveness of their procedures.

4. Cater to new patient acquisition channels.
Practices should find a niche of patients to serve within their community and heavily pursue those cases, whether they are the Medicare population or workers' compensation patients. LSI regularly works with new partners who can facilitate surgeries to LSI’s practice. LSI is a good fit for patients who injure their back and spine on the job because minimally invasive surgery returns patients to their normal activity and job quicker than traditional open surgery.

St. Louis says collaborating with the workers' compensation population and the personal injury is beneficial because these patients pursue more surgery integrated with conservative treatment.

5. Build a physician referral business. To increase patient volume in a practice, specialists should form a good relationship with primary care physicians responsible for the initial identification and referral of future patients. LSI has hired representatives to seek out medical professionals such as primary care physicians, physical therapist, chiropractors, etc., for mutual partnerships where the primary care physicians would refer patients to LSI and LSI would refer the appropriate individuals back to the primary care physician. These partnerships expand the practice's relationship within the medical community while also increasing patient volume.

Learn more about Laser Spine Institute.


Read more about spine practice management:

- Challenges in Spine Practice Management: Q&A With Laser Spine Institute Executive Director Lester Morales


- 9 Big Stories in Spine Surgery

- 10 Steps to Take to Add Spine to An Existing Surgery Center



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