Orthopedic, spine surgery, and pain management practices are experiencing a wave of consolidation, with private equity firms and health systems actively acquiring and building multisite platforms. Outpatient migration is accelerating, as more joint replacements, spine procedures, and pain interventions are performed in ambulatory surgery centers (ASCs), driven by advances in minimally invasive techniques and changing reimbursement models. Practices are also expanding into ancillary services such as imaging, physical and occupational therapy, durable medical equipment, biologics, urgent care, and occupational health to diversify revenue and improve patient outcomes.
At the same time, reimbursement pressures and regulatory scrutiny are intensifying. Medicare and commercial payers continue downward adjustments to reimbursements, while also expanding the types of surgical procedures that can be performed in an ASC. Orthopedic and other musculoskeletal (MSK) providers are also engaging more "bundled payment" and other innovative programs both with Medicare and commercial payors.
Baker Donelson's Health Care Transactions team provides comprehensive legal counsel to orthopedic, spine, and pain management practices navigating this dynamic environment. Our attorneys advise on strategic transactions, including practice sales, mergers, acquisitions, recapitalizations, and joint ventures with private equity sponsors, health systems, and strategic partners. We assist with facility development, including ASC formation, licensing, and ownership arrangements, as well as the integration of imaging, therapy, biologics, and urgent care services.
We also advise on management services organization (MSO) structures and governance models that comply with corporate practice of medicine (CPOM) laws and Stark and Anti-Kickback laws and regulations.
We also are active in connection with negotiation of professional service agreements, co-management arrangements, and other affiliation models with hospitals and health systems. Moreover, we have advised a number of orthopedic and spine surgeons who are dissatisfied with their hospital employment and professional service arrangements on separations that allow them to enter into new partnership transactions with MSK-focused investors and strategic platforms.
With deep experience representing orthopedic, spine, and pain management groups in strategic transactions, joint ventures, and ancillary service development, Baker Donelson is committed to protecting physician interests, maximizing practice value, and supporting operational growth.