By: Patsy Newitt, Becker’s ASC Review
In the competitive ASC market, joint ventures have become a cornerstone of growth. But Regent Surgical Health CEO Travis Messina argues that too many JV discussions begin in the wrong place: with management companies pitching solutions before understanding a partner’s true goals.
Founded in 2001, Regent Surgical Health partners with health systems and physician groups to develop, own and manage 26 ASCs across more than 13 states.
“When we meet a potential partner, they often ask, ‘Why should we pick you?’” Mr. Messina told Becker’s. “We pause and ask what they want to accomplish. Before selling a solution to a problem they may not have, we want to understand their goals.”
This philosophy has helped Regent Surgical carve out a distinct identity in the ASC marketplace, Mr. Messina said. The first step in structuring a joint venture is ensuring the partner can clearly articulate why an ASC or ASC network supports their broader strategy.
“If the partner can’t clearly articulate why they want an ASC or ASC network as part of their strategy, that’s a red flag,” Mr. Messina said. “Some want it because others do, without understanding why.”
With Regent, long-term goals and success metrics are mapped out from the outset.
“If you don’t define or measure success, you can’t improve,” Mr. Messina said. “So, we create long-term strategic plans right at the outset. Each year we update, but before any partnership, we need to know their enterprise objectives and whether we can advance them.”
Traditionally, ASC JVs have leaned heavily on physician ownership to secure buy-in. Regent, however, challenges the assumption that ownership is the only path to engagement.
Mr. Messina noted that physicians are often motivated just as strongly by operational advantages ASCs provide, including efficiency, patient experience and clinical productivity.
“It’s a perceived challenge that if a physician doesn’t have ownership in an ASC, you can’t get proper engagement,” he said. “But the ability to invest and generate a return isn’t the only motivator.”
Many health systems and physician groups rush into joint ventures without proper due diligence, Mr. Messina said. Regent emphasizes upfront transparency to avoid missteps.
“That upfront transparency helps align goals,” he said. “You can have the greatest ASC, but if it doesn’t fit their ecosystem, it won’t work.”
Mr. Messina outlined several red and green flags for partnerships. Green flags include clearly defined enterprise objectives, viewing ASCs as a strategic extension rather than just a revenue source, and openness to building a shared long-term plan. Red flags include pursuing an ASC simply because competitors are doing so or failing to articulate why outpatient surgery supports their mission.
The ASC sector is booming, driven by regulatory changes such as the elimination of the inpatient-only list and payer pressure to move cases to lower-cost settings. But Mr. Messina cautions against letting urgency override strategy.
“There’s demand to move quickly, but you need aligned philosophies,” he said. “Balancing speed with alignment is the biggest challenge.”