Dr. Scott Hannum, Partner at Emerge Ortho and President and Medical Director of Brunswick Surgery Center

Summary

Becker’s Healthcare Podcast Summary

Episode: Dr. Scott Hannam, Partner at Emerge Ortho and President and Medical Director of Brunswick Surgery Center
Host: Chanel Bunger
Release Date: June 28, 2025

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Introduction

Recorded live at the 22nd Annual Spine, Orthopedic and Pain Management Driven ASC plus the Future of Spine Conference, Chanel Bunger welcomes Dr. Scott Hannam to discuss key trends, technological advancements, and growth strategies in the realm of ambulatory surgery centers (ASCs) and orthopedic care.

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Guest Background

Dr. Scott Hannam introduces himself as a total joint orthopedic surgeon with 27 years of practice. He serves as a partner at Emerge Orthopaedics, a substantial independent orthopedic supergroup in North Carolina. Emerge Orthopaedics unites multiple independent groups across cities like Wilmington, Raleigh, Winston Salem, Greensboro, and Asheville. Under his leadership, the organization launched its physician-owned surgery center in Wilmington six years ago, successfully navigating the challenges posed by the COVID-19 pandemic. Today, the center conducts approximately 4,500 surgeries annually across four operating rooms, reflecting its significant growth and operational success.

Notable Quote:

"We've been successful and we made it through [COVID] and now we do about 4,500 surgeries a year and four operating rooms and very busy, very successful."
— Dr. Scott Hannam [01:19]

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Top Trends in Healthcare and ASCs

Chanel probes into the three top trends Dr. Hannam is observing in healthcare and ASCs:

1. Shift of Orthopedic Surgeries to Outpatient Settings:

   • Pre-COVID Momentum: The movement of orthopedic surgeries from hospitals to outpatient settings was already underway before the pandemic.
   • Acceleration Due to COVID-19: The pandemic served as a catalyst, compelling the adoption of outpatient procedures to mitigate hospital crowding.
   • Efficiency and Patient Outcomes: Dr. Hannam notes that 70-80% of orthopedic surgeries can be safely and successfully performed in ASCs, leading to better patient outcomes and lower infection risks.

   Quote:

   "Covid was a catalyst because we couldn't do surgery in the hospitals. But the trend of moving the majority of orthopedic surgeries to an outpatient setting was already happening."
   — Dr. Scott Hannam [02:46]

2. Regulatory Challenges and Access Issues:

   • Facility Limitations: Despite the benefits, there's a shortage of ASC facilities to meet the increasing demand.
   • Regulatory Hurdles: Various states impose stringent regulations on ASC ownership, construction, and operations, creating access barriers.

   Quote:

   "There's an access issue, which is a good and a bad thing for ASC."
   — Dr. Scott Hannam [03:10]

3. Reimbursement Discrepancies:

   • Economic Impact: The federal government reimburses ASC procedures at lower rates compared to hospitals, undermining the economic viability of ASCs.
   • Advocacy Needs: Dr. Hannam emphasizes the necessity for national lobbying efforts to address and rectify these reimbursement disparities.

   Quote:

   "Federal government, unfortunately, does not reimburse surgeries to be done at an ASC at the same rate that they do at a hospital... that is a threat and an issue that's influencing the economics of ASCs."
   — Dr. Scott Hannam [04:03]

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Focus and Excitement for the Second Half of 2025

When discussing his current focus and areas of excitement, Dr. Hannam highlights two primary areas:

1. Overcoming Access Challenges:

   • Enhancing Efficiency: Striving to make outpatient surgeries more accessible by improving operational efficiencies and cost-effectiveness.

2. Technological Advancements:

   • Artificial Intelligence (AI): Integration of AI in various facets of operations, including documentation, patient visits, operative notes, billing, and collections.
   • Robotic Surgery: Adoption of advanced surgical technologies to enhance precision and efficiency.
   • Economic Improvements: Belief that proper implementation of technology can lead to better healthcare economics by increasing efficiency and reducing costs.

   Quotes:

   "We're seeing [AI] incrementally in the way we document cases, the way we do patient visits... little AI programs that we're using for billing and collection."
   — Dr. Scott Hannam [04:48]

   "It's very fun, you know, to see where that goes and how that can make us even more efficient and improve... we can deliver better care to patients."
   — Dr. Scott Hannam [05:45]

Chanel reflects on Dr. Hannam’s optimism:

"A lot of cautious optimism."
— Chanel Bunger [06:15]

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Growth Strategies for the Upcoming Year

When asked about growth plans for the next year or so, Dr. Hannam delves into strategic partnerships and independent practice advocacy:

1. Partnerships with Like-Minded Orthopedic Groups:

   • Collaborative Networks: Through organizations like Pelto, Emerge Orthopaedics aims to unite independent orthopedic groups nationwide.
   • Collective Bargaining: Enhancing contracts with payers and suppliers by leveraging collective strength.

2. Employee Benefits and Competitive Edge:

   • Enhanced Coverage: Providing better healthcare coverage and benefits to employees to retain talent and maintain competitiveness.

3. Sustaining Independence:

   • Avoiding Red Tape: Maintaining independence from large healthcare systems and university affiliations to minimize bureaucratic complexities.

   Quotes:

   "Our biggest driver is how do we partner with other like-minded independent orthopedic groups around the country."
   — Dr. Scott Hannam [06:28]

   "It's a different model than being owned by a healthcare system or being owned by a university system, which has benefits but also has a lot of red tape and a lot of complexities."
   — Dr. Scott Hannam [07:15]

Dr. Hannam envisions this strategy to expand nationwide over the next three to five years, ensuring that independent practices can thrive amidst rapid changes in healthcare economics.

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Conclusion

Chanel Bunger wraps up the conversation by expressing gratitude to Dr. Hannam for his insights into the evolving landscape of orthopedic care and ASCs. Dr. Hannam reciprocates the thanks, highlighting the collaborative spirit of the discussion.

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Key Takeaways

• Outpatient Shift: The transition of orthopedic surgeries to ASCs is accelerated by COVID-19, offering better patient outcomes and reduced infection risks.
• Regulatory and Economic Barriers: ASCs face challenges in facility expansion due to regulations and lower federal reimbursement rates.
• Technological Integration: AI and robotic surgery are pivotal in enhancing operational efficiency and patient care within ASCs.
• Strategic Partnerships: Building nationwide alliances among independent orthopedic groups is crucial for sustained growth and competitiveness.

This episode provides a comprehensive overview of the current trends, challenges, and future directions in the orthopedic surgical landscape, emphasizing the importance of independence, technological adoption, and strategic collaborations.

Transcript

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[Chanel Bunger]

Hello and welcome to the Becker's Healthcare Podcast. My name is Chanel Bunger. Today I am recording live at the 22nd annual Spine, Orthopedic and Pain Management Driven ASC plus the Future of Spine Conference and sitting down with Dr. Scott Hannam, partner at Emerge Ortho and President Medical Director at Brunswick Surgery Center. Dr. Hannam, thank you so much for joining me.

[Dr. Scott Hannam]

Well, thank you for having me today. Perfect.

[Chanel Bunger]

Well, to get us started out, can you please introduce yourself and tell us a bit about your background in organizations?

[Dr. Scott Hannam]

So I am a total joint orthopedic surgeon by training. This is my 27th year in practice, which is hard to imagine. I am a partner at Emerge Orthopaedics. Emerge Orthopaedics is a large independent orthopedic supergroup in North Carolina. We've been in existence, I think about eight years now, and basically it was a collective of multiple different independent orthopedic groups in the state of North Carolina and Wilmington, North Carolina where I'm at, and then Raleigh, North Carolina, Winston Salem, Greensboro, Asheville, all kind of came together to form that large independent orthopedic practice. Eight years ago, we started our own independent physician owned surgery center in Wilmington that opened the doors six years ago right in the midst of COVID which was perfect timing on our part for a lot of chaos. But we were successful and we made it through and now we do about 4,500 surgeries a year and four operating rooms and very busy, very successful. So I have taken over the role and administrator and medical director of that facility in addition to my patient care duties.

[Chanel Bunger]

Got it, Got it. Well, now, moving into the meat of the podcast a bit, can you talk about three top trends that you're watching today in healthcare and ASCs today in your role?

[Dr. Scott Hannam]

Well, I think, and again, I'm sure you've already had people comment on this, but you know, the trend in orthopedics specifically, and Covid was a, a catalyst because we couldn't do surgery in the hospitals. But the trend of moving the majority of orthopedic surgeries to an outpatient setting was already happening. And then again, Covid accelerated it. And so we're definitely seeing that. There's no question that we can safely and successfully do 70, 80% of most, if not all orthopedic surgeries at an ASC. And so that's a good and a bad problem. It's good for patients. Patients, patient care is better, the outcomes are better, the risk of infections are lower, but we don't have the facilities to do that many surgeries. And there's a lot of regulations in many states in the country about opening ASCs, who can own them, how fast you can build them, et cetera. And so there's an access issue, which is a good and a bad thing for asc. So that's one huge trend, is the increasing numbers in orthopedic cases that have to be done. I think, you know, there's the marketplace of it. The federal government, unfortunately, does not reimburse surgeries to be done at an ASC at the same rate that they do at a hospital or even an outpatient hospital setting, which is inappropriate. It's the same surgery, it's the same care. If anything, we're more efficient and we're cheaper with better outcomes. And so that is a huge lobbying effort that has to be done on the national level, which is not easy. So that's. That is a threat and an issue that's influencing the economics of ASCs. Most definitely.

[Chanel Bunger]

Got it. Got it. And going to the second half of 2025, what are you most focused on and excited about?

[Dr. Scott Hannam]

Well, I think, you know, again, we talked about, you know, what's happening in the trends, and it's exciting. It's a challenge. You know, how do we. How do we overcome the access issue? How do we enable patients to have their surgery at an outpatient facility? I could be more efficient and be more cost effective in order to do that. So that's an exciting thing. I think technology is always fun. That's a fun trend. You know, again, everybody wants to talk about AI and what is AI doing, and 90% of people don't even know what it is, but they want to talk about it. But it's a reality and it's changing. We're seeing it incrementally in our way we document cases, the way we do patient visits, the way we do operative notes, little AI programs that we're using for billing and collection and listening ambient, all that yeah, all the above. And then even just the technology that we have in the surgery, you know, with robotic surgery and other things, that's very exciting. It's very fun, you know, to see where that goes and how that can make us even more efficient and improve. I think it will improve healthcare economics. If we can figure out how to do it correctly with the right vendors and the right smart people writing a good software, we can, we can be more efficient and deliver better care to patients.

[Chanel Bunger]

A lot of cautious optimism.

[Dr. Scott Hannam]

I think so.

[Chanel Bunger]

Yeah. Got it. And I've really enjoyed our time today. But before I let you go, I have one more question. How are you thinking about growth over the next year or so at your organizations?

[Dr. Scott Hannam]

Well, we are a big proponent of independent medical practices. So emerge. Ortho is probably the sixth or seventh largest independent orthopedic practice in the country. But even that is not enough. So our biggest driver is how do we partner with other like minded independent orthopedic groups around the country. So we have an organization called Pelto, which is a conglomerate of many different independent orthopedic groups from the west coast, from the Midwest, Northeast, and then also North Carolina. How do we come together to maintain independent practices, like minded care of patients, collectively improve the contracts that we have with payers, contracts we have with suppliers, provide better healthcare coverage for our employees and benefits for our employees. And so in order to stay competitive and to kind of deal with the rapid changes in healthcare economics, we feel that that's very important. It's a different model than being owned by a healthcare system or being owned by a university system, which has benefits but also has a lot of red tape and a lot of complexities. So that's our biggest growth driver in the next three to five years is how do we make that work and expand that hopefully nationwide.

[Chanel Bunger]

Absolutely. Well, Dr. Hannam, I want to thank you once again for your time today and for joining me on the Becker's Healthcare podcast.

[Dr. Scott Hannam]

Well, thank you for having me very much.