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All entries filed under “ASC Joint Venture”

G.I. / Endoscopy Centers - A Single Specialty Joint Venture Opportunity?

Driven by a rapidly-aging and better-informed population, together with expanded reimbursement (e.g., Medicare payment for screening colonoscopies), the demand for endoscopic procedures continues to increase dramatically. Current estimates show between 14 and 15 million outpatient endoscopic procedures being performed in the U.S. on an annual basis. Some experts predict that this volume will continue to increase at an annual rate of 20% to 30%.

While a majority (75% to 85%) of outpatient endoscopy is still being performed in a Hospital-based setting, there is a growing trend for such procedures to move to a freestanding/ambulatory care or office-based setting. This creates an excellent opportunity for Physicians and Hospitals to collaborate by creating a formal business Partnership to provide outpatient Endoscopy through a G.I. Center Joint Venture (JV).

Several immediate questions may come to mind: From a Hospital perspective, why not leave G.I. procedures where they are (i.e., do nothing) or build our own outpatient facility? From a Physician perspective, why not build our own facility (either a freestanding or an Office-based center) vs. working with the Hospital? Any one of the above alternative approaches could be taken – the result being that one party (either Hospital or Physicians) will ultimately benefit at the expense of the other. Should this occur, a potentially successful Partnership opportunity may instead result in a competitive or even adversarial relationship between parties.

The underlying theory behind a Physician-Hospital Joint Ventured G.I. Center is that both parties want to collaborate as a way to further strengthen traditional relationships.

Benefits to both Physician and Hospital under this scenario include proportionately sharing in construction/capital costs and financial risks; on the “up side”, the JV Partners share the potential improved financial result due to the increased efficiency and effectiveness a freestanding G.I. Center should produce. The Hospital frees up Operating or Procedure Room space which can be put to other revenue-producing purposes; the Physician gains the ability to share (based on ownership percentage) in the Facility component of Center billing as well as retaining the entire traditional Professional component. Higher quality service and enhanced proficiencies should result due to the focused provision of single specialty services in a higher volume fashion. Physicians also become more productive under this scenario and gain valuable schedule time to devote to additional professional/income growth or to personal activities.

The Patient’s perspective regarding a freestanding G.I. Center JV is clear: a needed service is received in a more efficient, effective and lower cost setting; lag time between scheduling and procedure performance is much less; the freestanding Center should be more convenient, comfortable and accessible (vs. a Hospital setting) due to its design and location. The Patient is ultimately much more satisfied as is typically reflected in Patient Satisfaction scores for freestanding Centers. The Community in general is also more satisfied and supportive of this collaborative approach when compared with the alternative competitive/adversarial relationship between Hospital and Physicians.

HVP is also hearing another more recent question: Haven’t the recent changes to Medicare ASC facility reimbursement for G.I. procedures made it very difficulty to have a successful freestanding G.I./Endoscopy Joint Venture? Clearly, G.I. is the Specialty being “hit” the hardest by the new Medicare payment system that began a 4 year phase-in period in 2008. Estimates are that Medicare G.I. reimbursement to ASC’s will decrease, on average, by 14% to 17% over this 4 year period. This is not surprising since this is where (along with Ophthalmology and Pain Management) Medicare spends most of its freestanding ASC dollars. Despite these significant payment decreases, HVP believes that a freestanding G.I./Endoscopy Center can still do well under the new Medicare system. The key to this success will be even greater attention to thorough business planning, effective facility design and excellent management leading to the achievement of all possible operational efficiencies.

The Hospital-Physician Joint Ventured G.I. Center may present a special opportunity. When properly developed and managed, the Center can offer services in a manner that emphasizes high quality, low costs and exceptional Patient satisfaction. Physicians, Hospital and Patient all stand to benefit greatly under this collaborative approach.

Healthcare Venture Professionals (HVP) can help Physicians or Hospitals get started with developing and operating a G.I./Endoscopy Center Joint Venture. To request more information, contact HVP at 615-457-1848 or visit our website at

Physician Hospital Joint Ventures

Ambulatory surgery centers or ASC’s are ideal Physician Hospital Joint Ventures (JV). Such ASC’s can be beneficial to both parties from a business perspective and can serve as a foundation for other subsequent efforts aimed at Physician Hospital collaboration.

Of equal or greater importance, Patients and the Community served tend to place tremendous value upon such facilities. They certainly enjoy the convenience and modern setting and equipment. They also like the fact that the local Hospital and its Doctors are partnering to bring such a facility to them. The impression (or image) that the Community has of the ASC partners can be greatly enhanced as a result of the facility. All in all, Patient and their Families usually express higher levels of satisfaction with the services provided in the new ASC setting.

In many markets, an ASC JV is a logical first choice when the Hospital has decided it would like to more-formally collaborate with members of its Medical Staff. A significant amount (up to 80% or more in some locations) of surgery being performed is now outpatient or ambulatory in nature. A mechanism to meet this growing trend in an improved fashion makes perfect business sense. It should also lead to expanded market shares of outpatient surgery for both the Hospital and involved Surgeons.

From a legal and regulatory point of view, the required path to follow in developing a Joint Venture ASC is well delineated. There are Companies, Legal Counsel, Architects, Equipment Planners and other professionals who have in-depth experience and expertise specific to the JV ASC model.

HVP itself specializes in both ASC’s and in the JV ASC ownership approach. Give us a call at 615-457-1848 so that we can talk personally with you about the JV ASC approach and how HVP can be of assistance to you. You can also learn more about our philosophy and experience in the ASC JV arena by visiting our website at

Physician / Hospital Collaborative Strategies

There are increasing opportunities for Physicians and Hospitals to consider unilateral development and ownership of various clinical Ventures.  This approach will continue to make good sense in select markets for a variety of strategic and business reasons.

As we look toward the future, however, HVP believes that a collaborative approach is still a preferred partnership model that makes the best long term business and strategic sense in many markets.  It is this belief that drives HVP to maintain a strong focus and special expertise related to Physician / Hospital Joint Ventures.  Although HVP’s core business is management, frequently we are asked to provide consulting services in situations where such collaboration is being considered.

Here are some highlights of what we’ve learned in helping our clients form successful partnerships:

Top 10 Lessons Learned: 

  1. Most Physicians prefer to look first to the Hospital (vs. national for-profit chains) as a potential partner for outpatient services.
  2. Hospitals that seek to proactively collaborate with their physicians get better deals than those who wait.
  3. Most Physicians prefer to collaborate with their local Hospital but will readily compete if the Hospital is not willing to “share the pie”.
  4. Physicians believe that Hospitals move too slow.  Hospitals believe Physicians are too impatient.  Both are frequently right.
  5. What you’ve heard is true:  “It is better to have 50% of something than 100% of nothing”.
  6. A single, successful Partnership “sets the table” for ongoing partner behavior where both parties are routinely looking for other collaborative opportunities.
  7. A growing number of Hospitals who now own 100% of a service (especially a Surgery Center) are actively considering converting these services to a JV.
  8. Most Physicians do not want the Hospital to have management control over the Partnership – they fear it will be run like a Hospital Department.
  9. A Joint Venture will improve your Hospital’s ability to recruit new Physicians – competition here is nation-wide and many locations will offer this option.
  10. A well conceived Joint Venture can result in a “bigger pie” for Hospitals and Physicians.

Top 3 Things Physicians Want in a Joint Venture:

  1. More control over operational decision-making;
  2. Better patient experience;
  3. Opportunity to replace lost income from lower reimbursement.

Top 6 Advantages for Physicians to JV w/ Hospitals:

  1. Easier access to capital
  2. Access to better payor contracts
  3. Access to group purchasing organizations
  4. Support of referral physicians
  5. State CON “clout” (where applicable)
  6. Preservation of relationship with the Hospital

If you are a Physician or Hospital representative and are considering collaborative strategies, HVP has the expertise and experience to assist you as you investigate or pursue such strategies.

ASC Joint Ventures

A pessimistic view of the world of healthcare would look like this: Hospitals, Physicians, Insurance Companies, Drug Companies and other healthcare Providers all have their own best interests at heart... More »

Joint Venture ASC

At Healthcare Venture Professionals, our core business is the development and long-term management of ASC’s. Within this core business is a strong emphasis, history and commitment to the collaborative... More »

Hospital Physician Collaboration

Healthcare Venture Professionals provides leadership and support to Hospitals and Physicians seeking to collaborate on the creation of a joint clinical venture for the provision of outpatient or ambulatory... More »

Hospital Physician Joint Ventures

Ambulatory surgery centers, or ASC’s, are one of the best examples of what can be profitable and mutually beneficial Joint Ventures (JV) between a Hospital and its Physicians. Healthcare Venture... More »

G.I. / Endoscopy Centers

Healthcare Venture Professionals continues to believe that the development of a free standing single specialty G.I. / Endoscopy Center is an excellent business opportunity in many situations. Given HVP’s... More »

Physician / Hospital Joint Ventures - Myth vs. Reality

Myth: An unfounded or false notion (Source: Merriam-Webster Online Dictionary) The number of Physician/Hospital ASC Joint Ventures continues to grow.  Like any other increasingly popular trend, the... More »