How One Entrepreneurial Patient Helped Found a Chain of Leading Outpatient Spine Institutes: Q&A With LSI Co-Founder Bill HorneWritten by Lindsey Dunn | May 18, 2010
Bill Horne, CEO of Laser Spine Institute, discusses how a 2004 surgery prompted him, along with his physician, James St. Louis, DO, to launch Laser Spine Institute. LSI marked its fifth anniversary in March and has grown dramatically since the 2005 opening of its flagship location in Tampa. Today, LSI operates seven facilities in four states, including Florida, California, Pennsylvania and Arizona and performs more procedures per month than any other spine care facility in the world, with a total of nearly 16,000 surgeries completed to date.
Q: What prompted you to found LSI?
Bill Horne: In 2004, I received a life-changing minimally invasive spine procedure from LSI's chairman of surgery and founder Dr. James St. Louis. Prior to my procedure, I was experiencing severe neck pain for 30 years as a result of a college football injury. Just one week before I was scheduled to receive open back surgery at a different facility, I had lunch with a friend who informed me of his wife's successful experience with a minimally invasive spine procedure in an outpatient setting.
After a consultation with Dr. St. Louis and learning more about his techniques, I canceled my previous surgical appointment and underwent a minimally invasive, endoscopic procedure. Following my procedure, I formed a close friendship with Dr. St Louis. I realized that the procedures performed by these pioneering surgeons were incredibly innovative compared to traditional spine surgery techniques, and I wanted to be able to educate people on the advantages and alternatives of minimally invasive spine procedures. Dr. St. Louis and I, along with fellow founder and medical director Dr. Michael Perry, formed a business partnership to establish Laser Spine Institute, opening the doors in March 2005.
Q: Given that many spine surgeries were not performed in the outpatient setting when you founded LSI, did LSI face any challenges convincing patients about the safety and effectiveness of outpatient spine procedures?
BH: We realized that although outpatient, minimally invasive spine surgery is entirely safe and not considered experimental, the procedure is still misunderstood, even among physicians and back and neck pain sufferers. To combat this problem, we began offering free seminars in cities across the U.S. and Canada to help educate prospective patients and provide an opportunity for open forum discussions.
Based on patient feedback at seminars, LSI adopted the medical consultation center model to provide further convenience and empower patients with a quick and easy, yet thorough assessment of their MRI/CT Scan, medical history and symptoms. At the consultation, individuals meet with a board-certified physician and determine their candidacy for minimally invasive spine procedures. The physician and patient discuss pain levels, conduct thorough pre-operative assessments and expertly review scans to determine the best course of action.
Q: What about payors? Given that outpatient spine remains a relatively new concept to some payors, did you meet resistance in negotiations with them?
BH: A key tactic at LSI is educating the patient and managed care company on what exactly we do since our procedures are still relatively new. Our chief objective is to educate the managed care payor, even if an agreement cannot be achieved in the short term.
LSI started as an ASC with a foundation built on in-house research. This led to incredible outcomes, which generated interest from payors and managed care companies desiring mutually favorable partnerships. Having our own medical research team follow patients post-operatively at pre-determined intervals provides valuable data for the managed care payors.
Managed care companies want to address financial issues. We address these concerns by sharing our statistics on patient satisfaction, surgical outcomes (re-surgery rates, complications, etc.) and costs associated with traditional spine procedures.
Q: How big of an impact are increasing out-of-pocket co-pays and co-insurance having on LSI?
BH: Over the last several years, the healthcare industry has seen a tremendous increase in cost-sharing with patients. LSI is experiencing the same obstacles as other providers, so to improve our time of service collections, we work with managed care companies and patients to determine what their out-of-pocket responsibility will be prior to surgery. We have also developed business relationships with external vendors who supply our patients with financing options independent of LSI. We are continuing to expand this payment arrangement so that even more patients can take advantage of this option. At LSI, we strive to offer patients every available option to enhance their patient experience.
Q: What has been LSI's number one key to success?
BH: As the leader in minimally invasive spine surgery, LSI has helped thousands of patients get back their lives through innovative and groundbreaking endoscopic procedures. Our incredible outcomes drive our success, with 91 percent of patients returning to work within 12 weeks of surgery.
Additionally, I believe LSI has been so successful because of the ultimate personal connection we have with our patients. We cultivate an environment that is patient centric, and through our superior service and incredible outcomes, we have earned the trust of our patients. Ultimately, this has led to the development of an institution that serves an increasing number of people while continuing to provide individualized care to each and every patient.
Learn more about Laser Spine Institute.
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