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SCALE CEO Leadership Series Vol. 11

Eric Rogers, CEO of Palm Vascular

Palm Vascular was founded in 2010 and currently operates a network of six state-of-the-art vascular OBLs, 20 podiatry practices and employs approximately 30 physicians primarily across the Florida market. The Company is one of the largest providers of integrated peripheral vascular care in Florida.  Below is an excerpt from the interview conducted with Eric Rogers. Download the PDF now for the full article.

DSO Market Landscape – A Market Transformed, Misunderstood & Ripe With Opportunity Ahead

There are approximately 200,000 dentists in the United States. When I started in the dental market in 2007, there was about 5% consolidation across the industry. Today, it’s closer to 20%. Watching this rate of consolidation was impressive. When I got involved with Dental Care Partners, we had 67 practices, Aspen Dental had about 100 practices, Heartland Dental had maybe 130 practices. Heartland Dental now for example has over 1,600 practices to give you an idea of just how much things have changed. Technology was few and far between back in 2007 comparable to what’s available today. Medicaid was misunderstood, probably 10, 15 years ago. Today, however, pediatric Medicaid and orthodontics Medicaid are broadly accepted as solid business models. 

Greatest Misconceptions About the DSO Investment Thesis

Paramount is the false assumption that the DSO market is already mature, in the ninth inning. The reality is that with 80% of the market of 200,000 dentists still fragmented, with 50% of the adult market untapped and with the role of technology in establishing value-based payments and expanding our reach into homecare and more services the best is yet to come. The second main false assumption is that the market hasn’t scaled well, with a few well publicized largescale DSO challenges. My view is that in a market of +150 DSO platforms, there were only a couple of bad actors in there that unfortunately created some of those misconceptions. Whether it was a failed DSO unable to meet its debt covenants or an incidence of Medicaid fraud, the number of these types of examples is less than a handful. The DSO industry consists predominantly of people who genuinely care about delivering great care and / or supporting others who deliver great care.

10 Key Actionable Takeaways within the Vascular Market

  1. Recent reimbursement cuts, while disruptive, do not change the larger opportunity
  2. Define your market potential and maturity by the number and size of your national competitors
  3. Our largest competitor remains physicians who decide to remain solo practitioners in small independent practices
  4. Opportunity to differentiate through broadening range of services built around a primary foundation – in this case a vascular offering
  5. Consider horizontal expansion across clinical specialties with a heavy focus on managerial expertise that needs to be added for new service lines. Do not assume your existing team knows the nuances needed to succeed in every new business line
  6. Beginning to see greater focus, appreciation and results negotiating strategic partnerships with local hospital groups
  7. Sophisticated marketing programs provide a powerful tool for empowering organic growth and de novo growth opportunities
  8. Focus on an attractive equity partnership model to ensure long-term loyalty among providers
  9. Don’t underestimate the value of stable long-standing executive team when it comes to allowing a CEO to focus on the greatest value creation opportunities
  10. There are plenty of new trends that will have an enormous impact on the category for years to come from the emergence of AI-based decision-making, to robotic surgeries, new EMRs, and the inclusion of new clinical programs such as hyperbaric oxygen therapy and cardiovascular outpatient procedures

In addition, we are very focused and dynamic with our marketing. As a result, we are very strong in developing new practice locations. We’ve tapped into multi-layered marketing tactics that are highly effective, and we’ve honed those skills over the years.

Download the PDF Now for the Full Interview

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