Ambulatory surgical center offers ‘fairly-priced’ alternative

The low-slung commercial building in Zionsville might be easy to miss, with its gray exterior and sloped roof.

But in large letters at the top, the name WellBridge Surgical pops out. For the thousands of cars passing daily on nearby Interstate 465, the outdoor signs give off an extra push to the company that does business inside.

“It’s a great billboard as you’re driving through 465 every day,” said Jeff Williams, the surgical center’s co-founder. “Everything starts slowing down right here, and you’re forced to look over and see us from around 3:30 to 5.”

Inside, the 3-year-old surgical center is quiet and antiseptic, with a large lobby, four operating rooms, a pre-op and post-op area, family consultation room, an admissions and discharge area, a physicians’ lounge and medical equipment stored on racks.

What WellBridge is selling is low-priced outpatient procedures, which the company says are about half the price charged by hospital outpatient facilities.

It is also selling price transparency, with an extensive website that lists prices for more than 250 procedures, ranging from an ear tube removal ($2,610) to a total knee replacement ($23,000).

Free market

WellBridge said it is operating under what it calls a “free-market model,” where it provides plenty of information on procedures to patients and companies. Company leaders say many hospitals are still providing minimal information and only when required under law.

“Much of it is still a closed market, meaning the lack of transparency and the inability of a health care consumer to be an active health care consumer,” said Dr. Eric Inman, an anesthesiologist and WellBridge Surgical co-founder. “But I’d say free market is how we are putting ourselves out there, using the same surgeons that operate at all the high-cost hospital systems.”

WellBridge does not have its own in-house roster of surgeons but uses surgeons from different surgical practices in the area, including some that perform surgeries at the biggest hospitals in town, Inman said.

WellBridge has performed about 3,000 surgeries since opening in 2021. But it has big ambitions; the company said it has capacity for about 6,000 surgeries a year and wants to grow.

Yet even if it achieves that higher number, it would still represent a comparatively modest figure in the Indiana market. The largest hospital system in the state, Indiana University Health, with 15 hospitals and numerous surgery centers, performed 73,572 outpatient surgeries during the first nine months of this year, up 3% from the same period a year ago, according to a filing last month.

The Indiana Hospital Association, a professional group representing about 170 Hoosier hospitals, said hospitals are a vital part of the health care landscape. It did not directly address the price issue.

“Indiana hospitals are there for every Hoosier, every day, regardless of their ability to pay,” the association said in a statement to IBJ. “While IHA supports competition in the market, which can lead to more options for patients, it’s also important to understand the vital role of a hospital to its community and the cost of providing essential, lifesaving care to all patients, 24 hours a day, 7 days a week, 365 days a year.”

“There’s always room for more competition in health care,” agreed Ed Abel, retired director of health care practice at Indianapolis-based Blue & Co., an accounting and consulting firm. “But independent surgical centers don’t have the same overhead and the same standards as a hospital.”

He pointed out that general acute-care hospitals must be staffed around the clock, and ready for any emergency. WellBridge Surgical, for its part, is open 8 a.m. to 4 p.m. on weekdays and is closed on weekends.

Growing trend

Ambulatory surgical centers—the name for the category that includes WellBridge—are outpatient facilities that perform surgical procedures, pain management, and some diagnostic services, and where patients typically go home the same day as their surgery.

The market for U.S. ambulatory surgery centers is expected to grow from $38.9 billion in 2023 to $55.7 billion in 2033, according to a forecast study by Canada-based Precedence Research.

“Surgical operations can be performed more affordably in ASCs than in traditional hospital settings,” Precedence said in a recent report. “Their reduced administrative expenses, streamlined operations and concentrated approach are reasons behind their cost efficiency. This frequently results in cheaper out-of-pocket costs for patients and less financial strain on the health care system.”

WellBridge Surgical had revenue of about $5 million in 2023, Inman said.

The company is not shy about listing and discussing its prices. “The most recent study by Rand Corp. revealed Indiana to be the fourth-highest surgical facility costs in the country,” the company’s website said. “That is precisely why we started WellBridge Surgical. To give you a fairly priced alternative to the ‘way it’s always been done.”’

And this: “Would you buy a car without knowing the price first? … Same surgeons. Difference place. Lower price.”

WellBridge Surgical’s business model is to talk to companies with self-funded health care plans and set up direct contracts with the surgery center. Self-funded health benefits plans require an employer to pay its workers’ medical claims rather than paying an insurance company to handle them. Many self-funded employers buy stop-loss insurance that kicks in for large one-time bills or when overall claims reach a high threshold.

“And so by cutting out a lot of the middlemen and different entities that maybe don’t necessarily bring value to the employer, we are able to let them directly contract with a multi-specialty surgery center for much lower cost,” Williams said.

Some employers who have used WellBridge Surgical say they are pleased with the services and low cost. Haynes International, a Kokomo-based manufacturer of alloys for the aerospace, industrial gas turbine and chemical processing markets, said it was on pace to save almost $400,000 this year in outpatient surgery costs by using WellBridge.

“We continue to be faced with the high cost of health care,” said John Patterson, the company’s senior human resources manager. “We said, ‘How can we reduce that?’”

One day, a couple of years ago, an outside benefits company knocked on Haynes International’s door, pitching WellBridge Surgical, which was an unknown entity to most people in Kokomo, about 50 miles away.

Intrigued, Haynes officials visited WellBridge Surgical’s facility in Zionsville and came away impressed with the cleanliness, low prices and seal of approval from the Accreditation Association for Ambulatory Health Care.

“This was not your typical surgical center as far as I was concerned, but we said, ‘Let’s give it a try,’” Patterson said.

Haynes officials sent the word to its employees: If they got an outpatient procedure done at WellBridge Surgical, they could save an average of $800 a procedure in out-of-pocket costs. He said the company recommended WellBridge Surgical but did not force employees to use it.

In the past two years, dozens of Haynes employees have used WellBridge Surgical for everything from upper endoscopies to knee replacements, Patterson said.

Ray Korson, a principal at Gibson Employee Benefits Practice in Indianapolis, said he is talking up WellBridge to his business clients.

“Any time you can find units costs for health care at half of what they would be through a traditional network, we have to be driving that as much as possible for those outcomes,” he said.

Better patient experience

WellBridge Surgical’s facility has a quiet feel to it. Williams and Inman, the co-founders who went through Carmel Clay Schools together as classmates and close friends, spent about $10 million to buy the building and renovate it.

Dr. Ronald Piniecki, a Zionsville anesthesiologist, was WellBridge’s third co-founder but left in 2013. His ownership interests were purchased by  the other two co-founders.

“Per the agreement, they are not able to discuss further,” an outside spokesman told IBJ. Piniecki did not respond to a phone call or a message left on his LinkedIn account.

The building is at 6300 Technology Center Drive in Zionsville, sandwiched between I-465 to the north and West 96th Street to the south. It was previously used as a campus for Harrison College, a for-profit system that went out of  business in 2018.

“This whole idea started in probably 2017 or 2018,” Williams said. “We bought the building and started construction in 2020 and opened in December of 2021. We are really focused on the patient experience, which we believe could get better, and quality outcomes.”

Two small examples of trying to improve the patient experience: All the pre-op and post-op bays are separated by drywall, not curtains, as some hospitals and ambulatory surgical centers do. And the building has consultation rooms off the lobby, so doctors can talk privately with family members, instead of in an open space.•