EXCEL HEALTH INVESTORS

EXCEL HEALTH
Scaling High-Acuity Endoscopic Spine.
Building a $230M+ National Platform on the "Ultra MIS" Advantage.
Investor Presentation | Strategic Growth Plan
Read our Investment Memorandum HERE
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.
2025 Performance: A High Growth Platform in Action
Proven Profitability Across Three Operating Entities
Our 2025 normalized EBITDA analysis demonstrates the strength of our existing platform and validates our expansion strategy.
Hon Spine (Flagship ASC)
Gross Revenue: $14.9M
Adjusted EBITDA: $2.1M
EBITDA Margin: ~20.5%
Enterprise Value Range: $18.4M - $27.6M (6x-9x multiple)
ENS (Clinical Practice)
Gross Revenue: $2.4M
Adjusted EBITDA: $450K
EBITDA Margin: ~18%
Enterprise Value Range: $900K - $2.25M (3x-5x multiple)
Excel Health (MSO Platform)
Normalized EBITDA: $378K
Platform coordination and optimization value
~17.3M
Total Revenue
~2.4M
Combined Adj. EBITDA
~21.6%
Blended Margin
$30M+
Estimated Platform Value
This existing profitability funds our expansion while demonstrating the model works at scale.
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.
Partnering for Platform Growth.
The Raise
$3M
To begin Phase 2: Acceleration (2026–2027).
Capital Allocation
Acquisitions & De Novo: Securing new key facility leases and licenses.
Procedure Optimization: Investing in inventory and equipment for Spine/Neuro capabilities.
Working Capital: Supporting operations and expansion while managing cash flow from collections.
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.