Capitalizing on the Migration of Complex Spine to the ASC.
The Opportunity
The shift of high-margin procedures—specifically Spine Fusions and Neuromodulation—from hospitals to Ambulatory Surgery Centers (ASCs) is the single largest value-creation event in healthcare services today.
The Problem
78% of ASCs are independently managed and lack the operational sophistication to handle high-acuity, implant-heavy cases.
The Excel Solution
We are an MSO platform aggregating and optimizing ASCs with a laser focus on the most profitable case mix: Minimally Invasive Spine Fusions and Advanced Neuromodulation.
$231.6M
Projected Revenue
2030
$36.6M
Projected EBITDA
2030
16
High-Volume Locations
Legacy ASCs Are Leaving Margin on the Table.
The "Generalist" Trap
Most of the 7,000+ US ASCs rely on low-margin, high-volume procedures (GI, Ophthalmology, General Surgery).
The Complexity Gap
Independent centers often struggle with the requirements for high-acuity spine care:
Complex payer contracting for high-cost implants.
Specialized inventory management for spinal cord stimulators.
Post-operative recovery logistics for fusion patients.
The Result
These centers remain underutilized, missing the wave of high-reimbursement cases that drive true profitability.
Unlocking Value Through Procedure Mix Optimization.
Our Competitive Advantage: Unlike generalist management firms, Excel Health is purpose-built to execute high-complexity, high-reimbursement procedures in an outpatient setting.
1
Spine Fusions
Targeting TLIF and ACDF, while layering novel endoscopic and disc replacement procedures.
These cases generate significantly higher revenue per encounter ($15k - $30k+) compared to standard ASC procedures.
2
Neuromodulation
Specializing in Spinal Cord Stimulators (SCS) and Peripheral Nerve Stimulators (PNS).
High-growth, tech-enabled pain management solutions with favorable reimbursement profiles.
3
The Result
By shifting the mix to these specific CPT codes, we dramatically increase Revenue Per Case and EBITDA margins compared to peer benchmarks.
A "Destination" Experience for Complex Recovery.
Why It Matters
Complex spine surgeries require a higher level of post-op care than simple procedures. Patients are willing to travel for the best outcomes and a comfortable recovery.
The Model
We strategically locate in premier destination markets (Honolulu, South Florida, SoCal) to attract medical tourists and high-net-worth patients.
Concierge Logistics
We manage the entire patient journey—travel, accommodation, and post-op nursing—turning a scary back surgery into a seamless, hospitality-driven experience.
Surgeon Appeal
This premium environment attracts top-tier spine surgeons who demand the best for their patients.
Phased Expansion to 16 Locations.
Phase 1: Foundation (2024–2025) (complete)
Solidify Core Locations (Honolulu + Aliso Viejo).
Implement "Procedure Mix Optimization" to maximize Spine/Neuro volume in existing suites.
Phase 2: Acceleration (2026–2027)
Expand to 7 Active Locations.
Revenue projected to jump to $65M+.
Integrate AI-driven patient intake to streamline high-acuity case approvals.
Phase 3: National Scale (2028–2030)
Reach 16 Mature Locations.
Expand footprint to Midwest and East Coast markets.
Achieve $230M+ Revenue Run-rate.
Financial Velocity & Scale.
Margin Expansion
2025 EBITDA Margin: 7.6% (Investment Phase).
2030 EBITDA Margin: 15.8% (Scale Phase).
The MSO Model: A fixed 5% Management Fee ($11.6M/year by 2030) provides defensive, recurring cash flow to the TopCo.
68%
Revenue CAGR
$10.5M to $231.6M
116%
EBITDA CAGR
Profit grows faster than revenue
The Power of High-Acuity Focus.
Revenue Per Location
While average ASCs generate $5M-$7M/year, an Excel Optimized Location targets $14M - $24M annually at maturity.
Volume
High-throughput efficiency and targeted patient marketing.
Value
Replacing 10 low-value procedures with 1 high-value Spine Fusion or Neurostimulator implant.
Marketing Efficiency
Because one patient generates significant revenue, our Customer Acquisition Cost (CAC) ratio drops to ~1% of revenue at scale, far lower than high-volume/low-margin models.
Experts in Spine, Operations, and Scale.
David Flickinger, CEO
Track record in ASC acquisitions and operational turnarounds.
Jeffrey Roh, MD, CMO
Board-certified Spine Surgeon. Deep expertise in minimally invasive techniques and surgeon recruitment.
BJ Dimartini, COO
Operational rigor in scaling multi-site healthcare services.
John Ciannamea, CFO
Financial structuring and M&A execution.
Clinical Advisory Board
Dr. Donald Corenman: Renowned Spine Surgeon & Educator.
Dr. Larry Khoo: Expert in Minimally Invasive Spine Surgery.
Partnering for Platform Growth.
The Raise
$3M
To execute the Phase 1 Growth Plan (2024-2025).
Capital Allocation
Acquisitions & De Novo: Securing the first 3 key facility leases and licenses.
Procedure Optimization: Investing in inventory and equipment for Spine/Neuro capabilities.
Working Capital: Supporting operations until positive cash flow inflection (Year 2).
The Exit Potential
Creating a $36M EBITDA platform commands a premium valuation (10x-14x EBITDA) from Private Equity or Strategic Buyers in the consolidating ASC market.