Big risk brings big opportunity, says company president


Nicholas Grosso, MD, is the chair of medical staff at the Center for Advanced Orthopedics in Bethesda, Maryland.

Dr. Grosso will be part of “The Next Move for Orthopedic and Spine Supergroups” panel at Becker’s 19th Annual ASC Spine, Orthopedics and Pain Management Conference. As part of an ongoing series, Becker’s speaks with healthcare leaders who plan to speak at the conference, which takes place in Chicago from June 16-18.

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Question: What issues do you spend the most time on today?

Dr Nicholas Grosso: We have officially launched MedVanta, the first MSO created in advanced orthopedics that has the market to help private practitioners who wish to remain independent of [private equity] and hospital systems. Since we just launched, it keeps me busy. On a typical day, what keeps me busy is the same thing that keeps any other leader of a large medical group busy: trying to cope with current challenges and those we see on the horizon. With this, we try to position our surgeons, physicians and providers to continue to provide the care they want in this private practice setting.

Q: What are your main challenges and how will they evolve over the next 12 months?

NG: Cybersecurity and compliance, I think, are the two most important, but cybersecurity is the ongoing consolidation throughout medicine, especially the musculoskeletal sector. We see PE entering the market to organize groups with hospitals trying to buy groups. We are committed to staying private, not taking money for physical education, and allowing our doctors to continue to practice private medicine as they see fit. It’s a big challenge. There is a lot of competition; many people with deep pockets come for our jobs. They want to do something with us, and at this point we’re just not interested.

The second big thing on the horizon is the evolution of medicine involving value-based care. This is very good and we welcome it. We’d love to come back after those payers every time we want to get an MRI or we can get pre-approval and everything. Achieving this requires a significant infrastructure. Smaller groups, seven, eight, nine, 10 guys, they just can’t afford to build the infrastructure they need to be successful at risk. One of the reasons we started MedVanta is because we’ve been successful since 2014. We’ve had the means to spend conservatively, but we’ve very carefully built the infrastructure we feel we need to move forward.

We wanted to get that third way, so they could stay in their private practice model, stay independent, make their own decisions, and basically be in charge of their own destiny.

Q: How do you see investments and growth over the next two years?

NG: For CAO, we rely on MedVanta to provide us with these facilities and the infrastructure we need to risk. We are going to spend a lot of time and money at the MedVanta level to build this infrastructure. For years, we’ve probably been building CAD from scratch. We always started with trusted consulting partners to provide services to us until we got to the point where we thought, okay, now we’re ready to take this particular segment into our own unit, in-house , and to hire someone to do this.

Q: What are you most excited about right now?

NG: Well, with great risk comes great opportunity. Things are constantly changing and you can’t be excited without being scared. We are very excited about the opportunities before us, because if we can get through this, we can do what we know we can do. We are very confident that we can turn around and do this for other groups as well. If we can achieve that, I think we will change medicine. Like I said, these bands don’t have a lot of options right now. They struggle to stay independent and alone. However, we hope that MedVanta will supply them or offer them a third way; a way to maintain that independence, at least as much as possible by associating with a group of like-minded physicians who are not held back by financiers, Wall Street or hospitals.


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