1 00:00:00,080 --> 00:00:02,639 This is Alan Condon with the Becker's spine 2 00:00:02,639 --> 00:00:05,359 and orthopedic podcast. And I'm thrilled to be 3 00:00:05,359 --> 00:00:08,880 joined today by Doctor. Nicholas Grosso and Doctor. 4 00:00:08,880 --> 00:00:11,359 Louis Levis, who are the co founders of 5 00:00:11,359 --> 00:00:13,299 the Centres for Advanced Orthopaedics, 6 00:00:14,014 --> 00:00:14,674 and Medvanta, 7 00:00:15,054 --> 00:00:16,835 which is the country's largest 8 00:00:17,135 --> 00:00:18,835 physician owned and operated 9 00:00:19,295 --> 00:00:19,795 musculoskeletal 10 00:00:20,254 --> 00:00:22,754 business and management services organisation. 11 00:00:23,214 --> 00:00:25,214 Doctor. Grasso and Doctor. Levitt, real pleasure to 12 00:00:25,214 --> 00:00:26,814 have you both on the podcast with us 13 00:00:26,814 --> 00:00:27,314 today. 14 00:00:27,922 --> 00:00:30,070 Before we dive into this discussion, I'd love 15 00:00:30,070 --> 00:00:31,589 to kinda hear a little bit from either 16 00:00:31,589 --> 00:00:32,170 of you. 17 00:00:32,549 --> 00:00:35,109 Do you mind sharing some insight into the 18 00:00:35,109 --> 00:00:36,250 driving factors 19 00:00:36,789 --> 00:00:39,670 behind that decision to set up Medvanta? Doctor 20 00:00:39,670 --> 00:00:41,369 Grasso, I'd love to hear from you first. 21 00:00:42,115 --> 00:00:43,795 Yeah. Alan, thank you for having us. 22 00:00:44,435 --> 00:00:46,515 Yeah. A few years ago, what we realized 23 00:00:46,515 --> 00:00:48,515 is what we had built with CAO was 24 00:00:48,515 --> 00:00:50,435 a we had all the tools that an 25 00:00:50,435 --> 00:00:52,914 MSO had, and we had so many other 26 00:00:52,914 --> 00:00:54,515 things that we wanted to accomplish in the 27 00:00:54,515 --> 00:00:55,015 musculoskeletal 28 00:00:55,395 --> 00:00:57,140 realm. You know, we wanted to build an 29 00:00:57,140 --> 00:01:00,020 end to end platform that would allow private 30 00:01:00,020 --> 00:01:00,500 practice, 31 00:01:01,219 --> 00:01:04,099 musculoskeletal providers to not only survive in this 32 00:01:04,099 --> 00:01:06,260 crazy medical environment that we're in, but also 33 00:01:06,260 --> 00:01:08,420 to to thrive. So that was the impetus 34 00:01:08,420 --> 00:01:11,204 about three years ago. We are fully self 35 00:01:11,204 --> 00:01:12,745 funded. Our docs and CAO, 36 00:01:13,444 --> 00:01:15,784 fully funded us as a separate investment vehicle 37 00:01:15,844 --> 00:01:18,645 to create MedVanta and give us the capital 38 00:01:18,645 --> 00:01:20,564 that we needed to build the tools that 39 00:01:20,564 --> 00:01:21,959 we have built thus far. 40 00:01:22,760 --> 00:01:24,280 And, so I think that's one of the 41 00:01:24,280 --> 00:01:25,959 things that I'm most proud about is is 42 00:01:25,959 --> 00:01:28,439 we are fully, positioned, funded, and owned. We've 43 00:01:28,439 --> 00:01:30,219 taken no outside money from anybody. 44 00:01:31,000 --> 00:01:33,400 Doctor Levitt, doctor Grasso kinda set the stage 45 00:01:33,400 --> 00:01:35,799 there, painted a picture for us. Anything to 46 00:01:35,799 --> 00:01:38,084 add from you in terms of, that driving 47 00:01:38,084 --> 00:01:40,244 factor decision behind with Vanta, what you're most 48 00:01:40,244 --> 00:01:41,305 excited about today? 49 00:01:41,765 --> 00:01:43,364 You know, I I do think and, again, 50 00:01:43,364 --> 00:01:44,884 Alan, thanks for having us on. But but 51 00:01:44,884 --> 00:01:47,444 I do think, you know, this, Centers for 52 00:01:47,444 --> 00:01:48,265 Advanced Orthopedics 53 00:01:48,724 --> 00:01:50,984 is the product of basically eleven years 54 00:01:51,364 --> 00:01:53,144 of sort of integration consolidation. 55 00:01:53,899 --> 00:01:55,920 And during that time, you know, our conversations 56 00:01:55,979 --> 00:01:57,439 were routinely with the payers, 57 00:01:57,739 --> 00:01:59,420 and they were baiting us with the idea 58 00:01:59,420 --> 00:02:01,179 that value based care is around the corner, 59 00:02:01,179 --> 00:02:02,939 and we'd better be prepared for that. And 60 00:02:02,939 --> 00:02:05,340 quite honestly, we spent that much time preparing 61 00:02:05,340 --> 00:02:06,079 our physicians. 62 00:02:06,379 --> 00:02:08,424 It didn't appear to be happening in the 63 00:02:08,424 --> 00:02:10,264 last few years no matter how hard we 64 00:02:10,264 --> 00:02:12,264 tried, but we built we built a platform 65 00:02:12,264 --> 00:02:13,164 and an infrastructure 66 00:02:13,625 --> 00:02:15,625 for doing value based care, and we decided 67 00:02:15,625 --> 00:02:18,344 that we'd spin off MedVanta. It it allowed 68 00:02:18,344 --> 00:02:20,504 us as a business organization to be more 69 00:02:20,504 --> 00:02:21,004 nimble, 70 00:02:21,305 --> 00:02:23,430 and and we knew two things. We had 71 00:02:23,430 --> 00:02:25,849 to solve the problem for access to physicians, 72 00:02:26,310 --> 00:02:28,870 but we also knew that acquisition of patients 73 00:02:28,870 --> 00:02:29,849 was now shifting, 74 00:02:30,150 --> 00:02:30,969 if you will, 75 00:02:31,590 --> 00:02:33,830 away from, you know, the doctor to doctor 76 00:02:33,830 --> 00:02:36,569 referral. So we decided to pivot towards, 77 00:02:37,145 --> 00:02:38,825 a a platform of services we can make 78 00:02:38,825 --> 00:02:39,325 available 79 00:02:39,865 --> 00:02:41,004 to direct to employers. 80 00:02:41,465 --> 00:02:43,625 And that's and that that really was the 81 00:02:43,625 --> 00:02:46,125 impetus to to spin off the business organization 82 00:02:46,425 --> 00:02:48,264 and shift our model to a a a, 83 00:02:48,264 --> 00:02:50,905 you know, a new clientele, if you will, 84 00:02:50,905 --> 00:02:52,460 away from the insurance 85 00:02:52,919 --> 00:02:54,840 company. Yeah. Absolutely. And I'm excited to kinda 86 00:02:54,840 --> 00:02:57,319 dive into the the direct to employer aspect 87 00:02:57,319 --> 00:02:59,719 in a little moment. But, yeah, I guess 88 00:02:59,719 --> 00:03:02,199 to to kick things off, doctor Levitt, I 89 00:03:02,199 --> 00:03:02,699 know 90 00:03:03,000 --> 00:03:03,659 with large 91 00:03:03,974 --> 00:03:06,395 health systems kind of increasingly dominating 92 00:03:06,854 --> 00:03:09,034 regional markets, we've seen orthopedic 93 00:03:09,335 --> 00:03:11,115 super groups and indeed MSOs 94 00:03:11,895 --> 00:03:13,034 provide independent 95 00:03:13,335 --> 00:03:15,914 practices with a real strategic advantage. 96 00:03:16,300 --> 00:03:18,719 But when we think about America's aging population 97 00:03:18,939 --> 00:03:21,039 driving greater demand for musculoskeletal 98 00:03:21,659 --> 00:03:24,560 care, how do you see the orthopedic landscape 99 00:03:24,699 --> 00:03:27,099 evolving in the coming years? What what strategies 100 00:03:27,099 --> 00:03:29,180 do you see being essential for independent groups 101 00:03:29,180 --> 00:03:30,000 to stay competitive? 102 00:03:30,715 --> 00:03:32,555 Well, I I think the aging population is 103 00:03:32,555 --> 00:03:34,174 living longer and is functionally, 104 00:03:34,555 --> 00:03:36,334 performing at a much higher level. 105 00:03:36,634 --> 00:03:38,634 And and they're the ones that are demanding, 106 00:03:38,954 --> 00:03:42,174 prevention and wellness, and and we're really pivoting 107 00:03:42,314 --> 00:03:43,134 towards that. 108 00:03:43,435 --> 00:03:46,909 Once again, as doctors retire and, the cost 109 00:03:46,909 --> 00:03:47,889 of of operation 110 00:03:48,430 --> 00:03:51,229 to practice is is really continuing to grow 111 00:03:51,229 --> 00:03:51,969 and increase, 112 00:03:52,430 --> 00:03:54,590 they're sort of dropping out and closing their 113 00:03:54,590 --> 00:03:57,250 practices. So with the boomer population 114 00:03:57,709 --> 00:04:00,555 so readily available, we have to provide a 115 00:04:00,555 --> 00:04:01,055 seamless 116 00:04:01,514 --> 00:04:03,215 access to physician care 117 00:04:03,514 --> 00:04:05,435 and be able to monitor that care as 118 00:04:05,435 --> 00:04:07,995 we follow patients through. And so we've made 119 00:04:07,995 --> 00:04:10,235 it easy, if you will, for patients to 120 00:04:10,235 --> 00:04:10,735 access, 121 00:04:11,275 --> 00:04:12,574 our our care providers 122 00:04:13,230 --> 00:04:15,150 and be able to to, if you will, 123 00:04:15,150 --> 00:04:17,250 shift the focus of our care providers, 124 00:04:17,550 --> 00:04:20,990 not just from surgical mindset to basically being 125 00:04:20,990 --> 00:04:21,730 care managers, 126 00:04:22,750 --> 00:04:25,649 in in in processing patients from the entrance 127 00:04:25,870 --> 00:04:27,470 of their injury all the way through to 128 00:04:27,470 --> 00:04:29,444 the completion of their care. That may result 129 00:04:29,444 --> 00:04:31,305 in surgery, but a lot more patients 130 00:04:31,605 --> 00:04:34,245 exist that don't ever have surgical management. And 131 00:04:34,245 --> 00:04:36,425 we're gonna take responsibility for those patients. 132 00:04:37,125 --> 00:04:37,625 Mhmm. 133 00:04:38,165 --> 00:04:38,985 Doctor Grasso, 134 00:04:39,444 --> 00:04:40,425 with so much 135 00:04:40,805 --> 00:04:41,305 consolidation 136 00:04:41,685 --> 00:04:43,865 in health care today, particularly in the orthopedic 137 00:04:44,610 --> 00:04:45,910 space. How does Medvanta 138 00:04:46,449 --> 00:04:49,990 empower independent orthopedic practices to remain competitive 139 00:04:50,370 --> 00:04:52,610 against some of these driving forces, large private 140 00:04:52,610 --> 00:04:55,330 equity backed groups, for example, corporate pay buyers 141 00:04:55,330 --> 00:04:57,014 to the tune of optimum and whatnot? 142 00:04:57,415 --> 00:04:58,935 So much happening in this space, but I'd 143 00:04:58,935 --> 00:05:00,535 be so curious to hear a perspective on 144 00:05:00,535 --> 00:05:01,035 that. 145 00:05:01,415 --> 00:05:03,335 Yeah. And and and Lou actually alluded to 146 00:05:03,335 --> 00:05:05,335 it. What he said, we think one of 147 00:05:05,335 --> 00:05:07,574 the biggest things going forward for private groups 148 00:05:07,574 --> 00:05:09,355 is patient acquisition and retention. 149 00:05:09,735 --> 00:05:11,919 The old ways of of getting patients from 150 00:05:11,919 --> 00:05:13,439 your buddy down the street who's a primary 151 00:05:13,439 --> 00:05:15,839 care provider or through the ER, those things 152 00:05:15,839 --> 00:05:18,319 are gone. Primary care providers are being purchased 153 00:05:18,319 --> 00:05:21,039 by hospitals or by PE back groups. So 154 00:05:21,039 --> 00:05:23,120 we really have to what we wanted to 155 00:05:23,120 --> 00:05:24,524 do and what we have done is we've 156 00:05:24,524 --> 00:05:26,524 created an end to end platform where we 157 00:05:26,524 --> 00:05:30,125 have digital tools proprietary to MedVanta, not using 158 00:05:30,125 --> 00:05:31,185 third party vendors 159 00:05:31,644 --> 00:05:33,564 that allow patients to have a digital front 160 00:05:33,564 --> 00:05:35,904 door, everything from what we call our Vantastat 161 00:05:36,044 --> 00:05:38,044 app, which is a app that can be 162 00:05:38,044 --> 00:05:41,110 downloaded from the Apple, I Store or Android. 163 00:05:41,329 --> 00:05:44,050 It allows patients to interact directly either by 164 00:05:44,050 --> 00:05:46,310 phone or by text with a live person 165 00:05:46,610 --> 00:05:48,930 and then get put into within twenty four 166 00:05:48,930 --> 00:05:50,449 to forty eight hours, see one of our 167 00:05:50,449 --> 00:05:53,250 providers. So, obviously, we're bypassing the urgent care 168 00:05:53,250 --> 00:05:55,875 centers. We're bypassing the ERs, and we're getting 169 00:05:55,875 --> 00:05:58,595 patients directly into groups that are working with 170 00:05:58,595 --> 00:06:00,915 Medvant, who have access to our app. And 171 00:06:00,915 --> 00:06:02,834 that's how we're gonna get these patients early, 172 00:06:02,834 --> 00:06:04,035 and then we're gonna take them through their 173 00:06:04,035 --> 00:06:06,435 entire episode of care through our other various 174 00:06:06,435 --> 00:06:07,875 tools that we've built all the way out 175 00:06:07,875 --> 00:06:09,800 the other end where where hopefully they're they're 176 00:06:09,800 --> 00:06:11,800 better and back to being active, whether, like 177 00:06:11,800 --> 00:06:13,959 Lou said, it's surgical or or or a 178 00:06:13,959 --> 00:06:15,979 nonsurgical care. It doesn't really matter. 179 00:06:16,519 --> 00:06:17,879 Well, we have all the tools to monitor 180 00:06:17,879 --> 00:06:19,000 them all the way through. So I think 181 00:06:19,000 --> 00:06:20,535 that's the biggest thing that we can help 182 00:06:20,855 --> 00:06:23,975 any any orthopedic or musculoskeletal group with is 183 00:06:23,975 --> 00:06:25,654 is how do you stay competitive? How do 184 00:06:25,654 --> 00:06:27,514 you keep getting patients in your door, 185 00:06:27,975 --> 00:06:30,074 and keep your keep the lights on, basically? 186 00:06:30,694 --> 00:06:32,295 And, Alan, I'm gonna add to that. We 187 00:06:32,455 --> 00:06:35,274 we're actually falling back on very old principles. 188 00:06:35,879 --> 00:06:38,120 For the most part, patients don't trust insurance 189 00:06:38,120 --> 00:06:38,620 companies, 190 00:06:39,080 --> 00:06:41,399 and and with private equity having entered into 191 00:06:41,399 --> 00:06:42,939 the market and institutions, 192 00:06:43,879 --> 00:06:45,100 large hospital systems, 193 00:06:45,560 --> 00:06:47,639 all seem to be motivated by the the 194 00:06:47,639 --> 00:06:48,134 profit, 195 00:06:49,095 --> 00:06:51,574 that that they can earn. We're falling back 196 00:06:51,574 --> 00:06:53,115 on the principle that the primary, 197 00:06:54,055 --> 00:06:56,214 essentials in medicine is for the physician to 198 00:06:56,214 --> 00:06:58,714 care for the patient. Our our motivation 199 00:06:59,574 --> 00:07:00,714 is patient outcome 200 00:07:01,175 --> 00:07:02,740 and and and not profit. 201 00:07:03,120 --> 00:07:03,939 And so, essentially, 202 00:07:04,399 --> 00:07:06,480 we think we add that to to to 203 00:07:06,480 --> 00:07:09,120 the marketplace now that's that's been missing for 204 00:07:09,120 --> 00:07:10,879 a long time, and we think that's gonna 205 00:07:10,879 --> 00:07:13,139 be attractive to patients going forward. 206 00:07:13,759 --> 00:07:15,759 Mhmm. I'd love to hear maybe a little 207 00:07:15,759 --> 00:07:18,125 bit more on some of those digital tools, 208 00:07:18,444 --> 00:07:20,524 doctor Levitt or doctor Grasso. I'm kinda curious 209 00:07:20,524 --> 00:07:22,444 on that aspect. Obviously, a big advantage there 210 00:07:22,444 --> 00:07:24,144 for practices joining Midvanta. 211 00:07:24,925 --> 00:07:27,584 We hear so much today about AI automation, 212 00:07:27,964 --> 00:07:30,524 revenue cycle management, big data. Are there any 213 00:07:30,524 --> 00:07:32,919 other tools that you anticipate on developing or 214 00:07:32,919 --> 00:07:34,199 rolling out in the future to help some 215 00:07:34,199 --> 00:07:36,439 of these practices in that space? Yeah. I'll 216 00:07:36,439 --> 00:07:38,120 I'll jump in there, Alan. We already have 217 00:07:38,120 --> 00:07:39,000 them. Right? So, 218 00:07:39,560 --> 00:07:41,399 one of the things, like Lou said, the 219 00:07:41,399 --> 00:07:43,800 profit motive taking care of patients has always 220 00:07:43,800 --> 00:07:45,720 been kind of FIFA service. You get paid 221 00:07:45,720 --> 00:07:47,535 for what you do. What we've gotta do 222 00:07:47,535 --> 00:07:49,694 as we go forward as musculoskeletal providers is 223 00:07:49,694 --> 00:07:51,134 figure out how do we stay whole, how 224 00:07:51,134 --> 00:07:52,194 do we stay, 225 00:07:52,574 --> 00:07:53,555 financially relevant, 226 00:07:53,935 --> 00:07:55,775 but caring for the whole person. So we 227 00:07:55,775 --> 00:07:59,215 actually have developed a wellness platform. It's we 228 00:07:59,215 --> 00:08:00,814 call it Vanta Motion. It's a two d 229 00:08:00,814 --> 00:08:02,194 to three d motion analysis 230 00:08:02,519 --> 00:08:05,480 that's been, clinically proven to be effective where 231 00:08:05,480 --> 00:08:06,779 we can evaluate people, 232 00:08:07,240 --> 00:08:08,920 whether they be employees at a at a 233 00:08:08,920 --> 00:08:11,399 company, whether they be pickleball players in the 234 00:08:11,399 --> 00:08:12,300 elderly population. 235 00:08:12,600 --> 00:08:14,759 And we could determine through our AI we 236 00:08:14,759 --> 00:08:17,394 have an in there as well as actual 237 00:08:17,935 --> 00:08:20,175 exercise physiologist that can review all that data 238 00:08:20,175 --> 00:08:22,194 and then make recommendations to the patient, 239 00:08:23,055 --> 00:08:24,414 of things they need to do to to 240 00:08:24,414 --> 00:08:26,894 hopefully prevent injury in the future. And, you 241 00:08:26,894 --> 00:08:29,069 know, you know, having an orthopedic surgeon talk 242 00:08:29,069 --> 00:08:31,470 about injury prevention may seem counterintuitive because we 243 00:08:31,470 --> 00:08:32,990 don't get you know, unless a patient comes 244 00:08:32,990 --> 00:08:34,190 to us with a problem, we we don't 245 00:08:34,190 --> 00:08:36,029 get paid. But we figured out a way 246 00:08:36,029 --> 00:08:37,549 that we can actually do this as a 247 00:08:37,549 --> 00:08:39,629 revenue generator for practices as well so we 248 00:08:39,629 --> 00:08:41,425 can do well by doing good, by have 249 00:08:41,504 --> 00:08:43,904 keeping patients healthy. And that's just one of 250 00:08:43,904 --> 00:08:45,684 our tools, and we've talked about the Vantastat. 251 00:08:46,305 --> 00:08:48,884 We also have a a a a online, 252 00:08:49,345 --> 00:08:49,845 basically, 253 00:08:50,305 --> 00:08:53,105 scheduling platform that can seamlessly integrate with any 254 00:08:53,105 --> 00:08:54,884 EMR that's already done. 255 00:08:55,269 --> 00:08:57,350 We also have an analytics platform that we've 256 00:08:57,350 --> 00:08:59,990 developed that allows us to look way deeper 257 00:08:59,990 --> 00:09:02,230 than just into our own EMRs, but to 258 00:09:02,230 --> 00:09:04,870 look longitudinally back through a patient's history through 259 00:09:04,870 --> 00:09:07,750 various data sources that we have to do 260 00:09:07,750 --> 00:09:10,514 things like risk scoring and risk analysis. So, 261 00:09:11,134 --> 00:09:13,855 we've already built all these things. They're already 262 00:09:13,855 --> 00:09:16,115 out there and and running for CAO. So, 263 00:09:16,495 --> 00:09:18,654 we're excited to show them to other folks 264 00:09:18,654 --> 00:09:19,554 around the country. 265 00:09:20,254 --> 00:09:22,414 Fantastic. So the app that you've mentioned, Vanta 266 00:09:22,414 --> 00:09:25,634 Motion, there's an online scheduling platform, an analytics 267 00:09:25,759 --> 00:09:26,259 platform. 268 00:09:26,879 --> 00:09:28,080 Thanks so much for sharing a little bit 269 00:09:28,080 --> 00:09:30,799 more of the specifics there. Doctor Levitt, I'd 270 00:09:30,799 --> 00:09:32,240 love to go back to you. You kinda 271 00:09:32,240 --> 00:09:34,339 mentioned this at the top of the podcast. 272 00:09:34,399 --> 00:09:36,899 But when we talk about direct to employer, 273 00:09:37,519 --> 00:09:40,555 Medvanta is obviously focusing on helping independent groups 274 00:09:40,555 --> 00:09:43,835 transition towards value based care and indeed direct 275 00:09:43,835 --> 00:09:46,235 employer contracting. Can you give us some insight 276 00:09:46,235 --> 00:09:47,995 into why these models are the future of 277 00:09:47,995 --> 00:09:50,634 orthopedic care and share some specifics into how 278 00:09:50,634 --> 00:09:52,254 Advanta is making them accessible? 279 00:09:53,210 --> 00:09:54,809 Well, number one, I think you put the 280 00:09:54,809 --> 00:09:57,450 doctor in charge of of the of of, 281 00:09:57,450 --> 00:09:59,309 basically, the the care pathway. 282 00:09:59,769 --> 00:10:01,549 And I think decisions are made, 283 00:10:02,250 --> 00:10:03,929 on behalf of the patient and and not 284 00:10:03,929 --> 00:10:05,309 not on behalf of the corporation. 285 00:10:06,004 --> 00:10:08,404 I also think that we know that if 286 00:10:08,404 --> 00:10:11,365 you look at most self insured companies across 287 00:10:11,365 --> 00:10:13,785 The United States right now, their largest spend 288 00:10:14,085 --> 00:10:15,144 is in the musculoskeletal 289 00:10:16,085 --> 00:10:16,585 domain. 290 00:10:17,125 --> 00:10:19,445 Women's health and cancer also occupies one of 291 00:10:19,445 --> 00:10:21,470 the top places, but but we have a 292 00:10:21,470 --> 00:10:23,549 very large volume of of of our own 293 00:10:23,549 --> 00:10:26,190 self insured employees. And we will verify that 294 00:10:26,190 --> 00:10:28,450 our biggest spend happens to be musculoskeletal 295 00:10:28,830 --> 00:10:30,990 spend, and it goes up every year no 296 00:10:30,990 --> 00:10:32,049 matter how hard 297 00:10:32,429 --> 00:10:34,725 we we we work to try to curb 298 00:10:34,725 --> 00:10:37,205 those costs. Well, we think this end to 299 00:10:37,205 --> 00:10:38,745 end integrated musculoskeletal 300 00:10:39,284 --> 00:10:41,625 solution that we call the MedVanta platform, 301 00:10:42,404 --> 00:10:43,144 of MSK, 302 00:10:43,684 --> 00:10:46,085 we're gonna offer that to an employer, and 303 00:10:46,085 --> 00:10:47,865 and we think that we can manage 304 00:10:48,279 --> 00:10:49,019 the musculoskeletal 305 00:10:49,720 --> 00:10:52,200 concerns that the patients have. And and Nick 306 00:10:52,200 --> 00:10:54,440 points out, you know, when someone comes in 307 00:10:54,440 --> 00:10:56,039 with a bad back, they go first to 308 00:10:56,039 --> 00:10:57,960 an urgent care center. It may be two 309 00:10:57,960 --> 00:10:59,480 weeks before they can see a doctor, and 310 00:10:59,480 --> 00:11:01,720 there's already perhaps an MRI scan that's been 311 00:11:01,720 --> 00:11:02,539 ordered unnecessarily. 312 00:11:03,720 --> 00:11:06,975 Our platform, for example, like the Vantastat or 313 00:11:06,975 --> 00:11:10,115 or the Vantor Connex products puts them right 314 00:11:10,174 --> 00:11:12,495 in the hands of either an orthopedic PA 315 00:11:12,495 --> 00:11:15,154 or a doctor. Seamlessly, they make an appointment, 316 00:11:15,375 --> 00:11:17,375 and we can usually keep them on-site and 317 00:11:17,375 --> 00:11:19,480 on work because we have such a large 318 00:11:19,480 --> 00:11:22,360 distribution of physical therapy services. If they require 319 00:11:22,360 --> 00:11:23,960 rehab, we can provide it near where they 320 00:11:23,960 --> 00:11:26,440 work. So we're gonna say to the the 321 00:11:26,440 --> 00:11:29,740 employer, we'll take the risk. We'll take responsibility 322 00:11:29,960 --> 00:11:31,340 for managing your musculoskeletal 323 00:11:31,745 --> 00:11:34,084 care and the third party point solutions 324 00:11:34,464 --> 00:11:36,945 that always seem to have the perfect solution 325 00:11:36,945 --> 00:11:39,184 to to managing them. Their goal is to 326 00:11:39,184 --> 00:11:41,184 keep the patient away from the doctor. Our 327 00:11:41,184 --> 00:11:42,625 goal is, in fact, to move the patient 328 00:11:42,625 --> 00:11:44,865 towards the doctor and produce the most optimal 329 00:11:44,865 --> 00:11:46,625 care, and I think that's gonna be attractive 330 00:11:46,625 --> 00:11:47,365 to the employer. 331 00:11:48,720 --> 00:11:51,059 Mhmm. Doctor Grasso, we're obviously seeing 332 00:11:51,360 --> 00:11:52,019 a lot of, 333 00:11:52,720 --> 00:11:55,379 independent groups banding together recently in the orthopedic 334 00:11:55,440 --> 00:11:57,700 space. A ton of, orthopedic MSOs 335 00:11:58,160 --> 00:12:00,639 like Advanta Midvanta appear over the last couple 336 00:12:00,639 --> 00:12:02,875 years. I'm curious to hear from you. Could 337 00:12:02,875 --> 00:12:04,634 you talk a little bit about the biggest 338 00:12:04,634 --> 00:12:05,454 growth opportunities 339 00:12:06,074 --> 00:12:08,315 Vanta is focusing on? Where are your big 340 00:12:08,315 --> 00:12:10,074 growth areas over the next two or three 341 00:12:10,074 --> 00:12:10,894 years or so? 342 00:12:11,674 --> 00:12:13,834 Yeah. So the yeah. That is definitely happening 343 00:12:13,834 --> 00:12:15,595 around the country, but you gotta look at 344 00:12:15,595 --> 00:12:17,009 these MSOs and see exactly 345 00:12:19,570 --> 00:12:21,330 most of the MSOs that I'm familiar with, 346 00:12:21,330 --> 00:12:24,529 the large, independent practice ones, they're they're doing 347 00:12:24,529 --> 00:12:26,629 some great stuff with, you know, 348 00:12:27,490 --> 00:12:29,490 on purchasing and certain other things that they're 349 00:12:29,490 --> 00:12:31,750 doing together, but they really have not developed 350 00:12:31,809 --> 00:12:34,745 any additional tools like MedVanta has because it 351 00:12:34,745 --> 00:12:36,524 takes such a large investment in, 352 00:12:36,985 --> 00:12:38,044 money and time. 353 00:12:38,584 --> 00:12:40,345 So we we know all these groups around 354 00:12:40,345 --> 00:12:42,105 the country. We talk to them, and we 355 00:12:42,105 --> 00:12:42,605 think, 356 00:12:42,985 --> 00:12:44,524 one of MedVanta's greatest 357 00:12:44,985 --> 00:12:45,485 potentials 358 00:12:45,809 --> 00:12:47,730 out there is working with these groups, right, 359 00:12:47,730 --> 00:12:50,370 and offering the services through them to providers 360 00:12:50,370 --> 00:12:52,529 in their area. Gives us almost a national 361 00:12:52,529 --> 00:12:53,029 reach, 362 00:12:53,570 --> 00:12:54,470 through the orthoform, 363 00:12:55,330 --> 00:12:56,710 with its 5,000 364 00:12:56,929 --> 00:12:59,330 or more orthopedic surgeons distributed, and I think 365 00:12:59,330 --> 00:13:02,174 it's 48 states now, 47, 40 eight states. 366 00:13:02,174 --> 00:13:04,735 We can go to basically any any employer 367 00:13:04,735 --> 00:13:06,415 in the country and say, if we can 368 00:13:06,415 --> 00:13:07,955 work with these groups in the orthoform, 369 00:13:09,215 --> 00:13:10,915 we we could provide a nationwide, 370 00:13:11,695 --> 00:13:14,559 coverage for for employers who may have people 371 00:13:14,559 --> 00:13:16,639 who are outside of, like, Centers for Advanced 372 00:13:16,639 --> 00:13:17,139 Orthopedics, 373 00:13:17,759 --> 00:13:19,839 catchment area, which is basically Maryland, DC, and 374 00:13:19,839 --> 00:13:22,339 Northern Virginia. So I think that's the biggest 375 00:13:23,039 --> 00:13:25,759 upside out there is, we think it's great 376 00:13:25,759 --> 00:13:28,634 that private practice groups are banding together to 377 00:13:28,634 --> 00:13:30,315 to stay healthy and to stay relevant, and 378 00:13:30,315 --> 00:13:31,675 then we just think we're gonna take them 379 00:13:31,675 --> 00:13:32,654 to that next level. 380 00:13:33,355 --> 00:13:35,615 I also think, Alan, that we've we're approaching 381 00:13:36,235 --> 00:13:36,735 musculoskeletal 382 00:13:37,195 --> 00:13:38,815 care as a regional problem. 383 00:13:39,835 --> 00:13:42,715 Yes, we have a national appeal, but CAO 384 00:13:42,715 --> 00:13:43,615 is our anchor 385 00:13:43,919 --> 00:13:46,580 orthopedic group as we go direct to employers 386 00:13:46,720 --> 00:13:48,639 in in our region. And we'd like to 387 00:13:48,639 --> 00:13:51,700 go across the country and create anchor orthopedic 388 00:13:51,839 --> 00:13:54,179 groups through the orthopedic forum network 389 00:13:54,799 --> 00:13:57,220 in other regions and then use our tools 390 00:13:57,759 --> 00:14:00,205 to basically transfer the same services to the, 391 00:14:00,445 --> 00:14:02,205 direct to the employer model and and their 392 00:14:02,205 --> 00:14:03,264 location as well. 393 00:14:03,964 --> 00:14:06,524 Got it. So, two fantastic leaders. I really, 394 00:14:06,524 --> 00:14:09,164 really appreciate both your time. Not just fantastic 395 00:14:09,164 --> 00:14:11,424 leaders at CAO, but also Medbanta 396 00:14:11,840 --> 00:14:13,840 and indeed your own practices as well. Don't 397 00:14:13,840 --> 00:14:15,360 know where you find the time to squeeze 398 00:14:15,360 --> 00:14:17,679 it all in. But I'd love to end 399 00:14:17,679 --> 00:14:18,179 on, 400 00:14:18,639 --> 00:14:20,320 kinda hear from each of you. Doctor Leveld, 401 00:14:20,320 --> 00:14:21,940 I'll go to you first. So I guess 402 00:14:22,080 --> 00:14:23,299 orthopedic surgeons, 403 00:14:23,759 --> 00:14:25,600 what is the next kinda big trend that 404 00:14:25,600 --> 00:14:27,600 you they should be paying most attention to? 405 00:14:27,600 --> 00:14:29,095 Are you coming at this from a surgical 406 00:14:29,095 --> 00:14:31,975 technology standpoint, a different trend standpoint? Love to 407 00:14:31,975 --> 00:14:33,975 kinda hear just wrap up the podcast with 408 00:14:33,975 --> 00:14:35,495 a an insight from each of you on 409 00:14:35,495 --> 00:14:36,154 this question. 410 00:14:36,774 --> 00:14:38,855 No. Look. I've I've been an orthopedic surgeon 411 00:14:38,855 --> 00:14:41,575 for forty years, and I've seen sort of 412 00:14:41,575 --> 00:14:43,960 trends come and go. But but we've always 413 00:14:43,960 --> 00:14:44,700 been surgeons, 414 00:14:45,399 --> 00:14:47,160 and I I think that for me, the 415 00:14:47,160 --> 00:14:50,040 biggest shift in orthopedics is we have to 416 00:14:50,040 --> 00:14:52,440 start taking responsibility for the full care of 417 00:14:52,440 --> 00:14:54,820 the patient from the outset of their injury 418 00:14:54,820 --> 00:14:55,990 or their beginning of their 419 00:14:58,534 --> 00:14:59,034 arthritis 420 00:14:59,335 --> 00:15:01,654 and take responsibility for managing them through the 421 00:15:01,654 --> 00:15:04,615 entire, you know, duration of their health care 422 00:15:04,615 --> 00:15:05,995 trip, if you will, 423 00:15:06,534 --> 00:15:08,875 and become the trusted care providers 424 00:15:09,559 --> 00:15:11,320 to try to produce again the the best 425 00:15:11,320 --> 00:15:13,079 outcome at the lowest price. And and I 426 00:15:13,079 --> 00:15:15,019 think the shift away from just being surgeons 427 00:15:15,399 --> 00:15:17,480 to being full care providers to me is 428 00:15:17,480 --> 00:15:19,100 the biggest change in the future. 429 00:15:19,879 --> 00:15:22,199 Doctor Grasso? I'm just gonna echo that because, 430 00:15:23,000 --> 00:15:24,425 I I think the biggest shift is a 431 00:15:24,425 --> 00:15:26,605 mindset shift, from being the technologist 432 00:15:27,225 --> 00:15:28,605 to being the care manager, 433 00:15:29,065 --> 00:15:31,384 of of the MSK world. Right? And, you 434 00:15:31,384 --> 00:15:32,904 know, you gotta look at the patient in 435 00:15:32,904 --> 00:15:34,345 a way that is very different than we've 436 00:15:34,345 --> 00:15:36,105 ever looked at the patients before. You gotta 437 00:15:36,105 --> 00:15:38,559 look at them. You know? We can't just 438 00:15:38,559 --> 00:15:41,620 punt things like diabetes and obesity and smoking, 439 00:15:42,399 --> 00:15:45,679 and mental health issues and, social determinants of 440 00:15:45,679 --> 00:15:47,839 health to primary care because they don't do 441 00:15:47,839 --> 00:15:49,279 a very good job with it either. So 442 00:15:49,279 --> 00:15:51,565 we start we have to and we have 443 00:15:51,565 --> 00:15:53,345 the tools and see and, MedVanta 444 00:15:53,804 --> 00:15:54,304 to 445 00:15:54,845 --> 00:15:56,605 deal with these things, to take a patient 446 00:15:56,605 --> 00:15:58,065 who may have some comorbidities, 447 00:15:58,444 --> 00:16:00,365 who may have some things that are could 448 00:16:00,365 --> 00:16:02,959 be optimized before a procedure and and and 449 00:16:02,959 --> 00:16:04,879 take them through that. And that's something that 450 00:16:04,879 --> 00:16:07,279 we as orthopedic surgeons have to accept because 451 00:16:07,279 --> 00:16:08,799 that's gonna be our new role, and that's 452 00:16:08,799 --> 00:16:09,860 how we're gonna really 453 00:16:10,319 --> 00:16:12,480 succeed in this value based care world. It's 454 00:16:12,480 --> 00:16:14,495 it's not just on a per click fee 455 00:16:14,495 --> 00:16:16,575 for service, do a case, get paid, see 456 00:16:16,575 --> 00:16:18,174 a patient get paid, but taking care of 457 00:16:18,174 --> 00:16:20,334 the whole patient from end to end and 458 00:16:20,334 --> 00:16:21,794 figuring out a way with MedVanta 459 00:16:22,174 --> 00:16:24,414 to make that financially viable to to be 460 00:16:24,414 --> 00:16:25,394 able to do that. 461 00:16:25,934 --> 00:16:27,534 Alright. Thanks. So next one, feel for Todd 462 00:16:27,534 --> 00:16:30,160 and great insights to round out our discussion 463 00:16:30,160 --> 00:16:32,340 today. And doctor Grasso, doctor Levitt, 464 00:16:32,800 --> 00:16:34,320 again, thank you so much for taking the 465 00:16:34,320 --> 00:16:35,759 time to speak with us on the Beckers 466 00:16:35,759 --> 00:16:38,560 podcast. So greatly appreciate and respect the the 467 00:16:38,560 --> 00:16:40,720 excellent work that that indeed you and your 468 00:16:40,720 --> 00:16:43,360 respective teams do, and look forward to catching 469 00:16:43,360 --> 00:16:45,267 up with you both down the line. Alright, 470 00:16:45,267 --> 00:16:46,627 Al. Thank you for giving us the time. 471 00:16:46,627 --> 00:16:48,647 We appreciate it. Thank you very much.