IOR Partners

Valued at over $800 billion, healthcare is the largest and fastest growing economic sector in the U.S. It is comprised of a myriad of participants, including patients, payors, physicians, professional societies, multiple settings of care, and a steady flow of technological advancements. Given the enormity of the sector and the individual interests of its constituents, healthcare is nearly impossible to transform – even though such transformation is needed as the U.S. ranks 22nd out of 27 high income nations when analysed for its efficiency of dollars spent.

Ophthalmology and its progressive ability to evolve, has shown to be a great exception to this rule. It was only 50 years ago when cataract surgery was performed in the hospital requiring at least a three day stay. As technology advanced and payor pressure to limit inpatient utilization increased, cataract surgery, the most common medical procedure performed, made a dramatic shift from the hospital setting to the ambulatory surgery center (ASC). This shift resulted in the nearly elusive trifecta of healthcare - better outcomes, greater convenience (for the patient and physician) and lower cost for the payor. While many resisted this shift at the time, ASCs are now the predominant setting for cataract surgery where the patient is in and out in a matter of a few hours versus a few days.

Today, the spotlight is once again on cataract surgery, but for different reasons. The number of cataract procedures has grown from 1 million in 1985 to an expected 4.5 million in 2023. The number of individuals with cataracts in the U.S. is projected to be 38.5 million in 2023, increasing to 45.6 million by 2050. And while the demand continues to grow, the number of ophthalmic surgeons is declining and their available surgical time in the ASCs is being de-prioritized for more lucrative procedures. This has created a dangerous imbalance of supply and demand for the world’s most common medical procedure.

Can ophthalmology step up once again to solve this critical supply and demand problem? Can it be done while delivering safe and effective outcomes at a lower cost? Will it align the best interests of the patient, physician and payor? One company thinks so and is already making great progress.

Transforming the Way Ophthalmic Surgery is Performed

Answering this need is iOR Partners, a company leading the movement towards office-based surgery in ophthalmology. Office-based surgery (OBS) is any surgical or invasive procedure performed by a licensed physician in the office setting. iOR has developed the model for ophthalmic OBS and is modernizing the delivery of procedures for cataracts, retina, glaucoma, refractive lens exchange, and oculoplastics making surgery more accessible for patients and more cost-effective for the healthcare system. With historical expertise and leadership in ophthalmology, iOR Partners is revolutionizing the way ophthalmic surgery is performed and is helping surgeons integrate clinic and surgery for more streamlined patient care.

Like the shift of ophthalmic surgeries from hospitals to ASCs, iOR addresses the demand for these procedures in the aging population, necessitating an effective and safe solution to tackle the capacity issues.
“OBS is a high-quality and cost-effective complementary option to traditional ASCs, offering better continuity of care while reducing the financial burden of cataract surgery on Medicare and commercial insurance groups,” says James R. Williams, President & CEO of iOR Partners. “When surgery takes place in a physician’s office, patient care is streamlined and more personalized. Patients are also familiar with the environment and staff, which reduces their anxiety and provides them with a better experience.”

However, the challenges associated with setting up an OBS suite make surgeons reluctant to adopt this model on their own. Most physicians lack the necessary knowledge to plan for the infrastructure and costs associated with building an OBS suite. There are also concerns about ongoing management, accreditation and compliance, equipment needs, surgical staff training, and back-end office operations - administrative functions provided by the ASC that most surgeons have little awareness of. That is where iOR comes in.

A Rare Healthcare Model that Unites Patients, Physicians and Payors

iOR’s value proposition is anchored in a comprehensive, turnkey approach that includes support for space design and buildout, equipment selection, staff training, materials management, reimbursement support, accreditation, and ongoing day-to-day oversight. This relieves the physicians of these duties, which allows them to focus on what they do best and enjoy most – patient care. iOR Suites® seamlessly integrate clinic and surgery schedules within the surgeon’s office, increasing patient capacity and retaining all surgical revenues within the practice. In exchange for the value provided, iOR charges a development fee and a per case rate.

“We are also generating complementary revenue streams for physicians. Ophthalmology is one of the few specialties that allow them to upgrade their patient services. For example, if better quality lenses are available than the standard ones provided to Medicare patients, we can deliver the upgraded lens, and the patient is only charged for the additional cost,” says Williams. “By building a relationship with the patient, we can design a collaborative model that would attract pharmaceutical and device companies as well.”

iOR’s model provides a rare healthcare offering that unites and aligns all key stakeholders - the Physician, Payor, Patients under a common program that benefits all participants:

• Physicians enjoy complete control of their surgical schedule (24/7/365), increased productivity (no travel to or waiting at the ASC), an enhanced quality of life/work balance and additional revenue opportunities.
• Patients enjoy flexible, convenient scheduling and being treated by familiar staff and surroundings that are less intimidating than an ASC.

• Payors benefit from the safety and effectiveness, while the lower cost structure of an OBS drives reimbursement savings.

• And, from a National Healthcare perspective, OBS adds much needed capacity and reduced cost to the supply and demand crisis facing cataract surgery.

OBS is a major step forward in quality, safety, convenience and cost savings and iOR is the established leader in the field. There are already over 70 iOR Suites open or in development in 30 states. The company is expecting continued growth as the number of prospective physicians is increasing by more than 35 percent year over year.

Data Collection Drives Value and Future Growth Opportunities

A benefit to iOR’s business model is the surgical data they are able to collect. The company has developed the iRWD Registry™ that consists of real-world data from cases performed in iOR surgical suites as part of its accreditation program. Quarterly occurrence data is collected from multiple OBS centers and surgical techniques. Over 32,000 procedures have been safely performed in iOR Suites, which match or exceed safety outcomes in other outpatient settings. This data has resulted in two landmark research studies, one of which has been accepted for publication in the Journal of Cataract & Refractive Surgery, and is used to work with the Joint Commission and Quad A to develop quality standards that all OBS centers can comply with.

“We place immense value on the data collected, which enables pharmaceutical and medical device companies to test new devices and medicines. These are some of the many avenues that can be leveraged to expand our model,” says Williams.

Proud of its proven business model that shows promising data centered around OBS, iOR is working on scaling and capitalizing it further.

“Currently, we are raising Series C funding for scaling that will go into internal infrastructure, including IT, to ensure we deliver sustainable, consistent results in every aspect of the business,” says Williams.

iOR Partners is also exploring other complementary services that can be added to the practices, such as virtual consultations, to improve conversion rates for premium services and build more revenue streams for providers. The company is considering expansion of its successful model to other specialties, like urology and dermatology.