Image by Colin Behrens from PixabayThe ambulatory surgery center (ASC) industry is entering a new era – one that’s marked by higher-acuity care, increasingly complex joint ventures and an urgent need for infrastructure that can support rapid growth.
Compass Surgical Partners is betting that a multi-sector operator with experience in both scaling and transformation is the right person to help lead that charge.
The ASC management and development company recently named Chris Fromme as its new chief operating officer. Fromme brings a unique perspective shaped by time in behavioral health, dental and ASC roles, having most recently served as CEO of Star Dental Partners and previously as COO of Behavioral Innovations.
But his roots in the surgery center space run deep, with past leadership roles at United Surgical Partners International (USPI) and early exposure to the joint venture model that still drives much of the industry today.
ASC News caught up with Fromme to learn about his background and what he’s prioritizing as Compass’ COO. Highlights from that conversation are below, edited for length and clarity.
ASC News: I thought we could start with looking at your background broadly. You served as the CEO of Star Dental Partners. Before that, you were in the behavioral health space. What lessons do you take from those roles and bring to Compass now?
Fromme: The thread throughout my entire career is working with all provider-led, multi-site businesses. Whether it be a physician, a surgeon, a behavior analyst in the autism space, a dentist, or even physical therapy early in my career, it’s all multi-site, multi-state, provider-led.
And it comes down to the two most important individuals in these businesses: the patients and the providers. In our business, the providers bring the patients. That’s the common theme.
And before those two roles, you were with USPI. Is that where you really began to get heavily involved with the ASC model? When did you realize the ASC space was one you wanted to be a part of?
I actually got introduced to it before that actually. I worked for a company that’s no longer in existence (it was purchased by SCA/Optum). It was a small surgery center provider based out of Colorado. But they focused on three-way joint ventures: the management company, doctors, and a health system or hospital.
I cut my teeth with them on the three-way JV concept, which was attractive to USPI. I don’t know if USPI invented the three-way model, but they proved it out and proliferated it around the country. After three years with Health Inventures, I joined USPI in 2011.
It’s a really transformative time for the ASC space. There are a lot of organizations looking for great leaders to help them grow and write their story in the industry’s next chapter. The stars aligned with you and Compass. What made this a really good fit?
I’ve worked in different health care verticals, and I enjoy doing new things, so those experiences have been rewarding. Autism and dental, I would say, was more “fringe” health care – not in a disrespectful sense but rather they’re not what you think of when picturing “traditional health care.”
I missed the hospital and surgery center environment. When the opportunity with Compass presented itself, I met [CEO DJ Hill] and the team, and we were aligned on what’s important: patients and physicians, like we already talked about. That’s the focus. If you can’t figure that part out, it’s hard to be successful in the business. The way I saw the business as an operator – and how to be successful – was very similar to how the Compass team saw it.
What do you see as the defining forces shaping the industry right now? You’ve already touched on joint ventures. I’m sure that’s one. What other major narratives are you keyed in on?
I think it’s pretty common knowledge: More and more procedures and surgeries continue to trend outpatient, right?
As technology advances, as patient care advances, things come out of the hospital into the outpatient environment. That train has been rolling for a while, and it has even accelerated more in the last decade.
In the last decade, total joints, cardiovascular and spine started moving out of the hospital, and that continues.
There’s that trend, and consolidation continues. It’s hard being an independent surgery center with all the complexity – the clinical and regulatory complexity. People are aligning with hospitals and health systems to help them navigate all of that.
But hospitals and health systems aren’t great at that, right? They’re great in the typical inpatient-type work and in setting up primary care networks – things like that. That’s why companies like Compass exist – to help health systems expand their footprint out into the neighborhoods rather than just be hospital centric.
Looking ahead at next year, how do you see those themes changing or staying the same? Do you see any new trends popping up in 2026 that you’d like to call out? For instance, I know we’re always thinking about the rising cost of labor, what payers are prioritizing, regulatory changes, etc.
I think the high-acuity trend will keep accelerating.
And health systems a little late to this trend will start paying more attention. It used to be, 20 years ago, a lot of the health systems wanted to hold onto the business in the inpatient or HOPD setting. That’s harder now, with all the dynamics you just mentioned.
There are a lot of health systems that were relatively late in really defining their strategy, and so that’s a big opportunity for our organization – to partner with folks who want an outpatient strategy but haven’t yet developed one.
And JVs and M&A, is that going to be a focus as COO? I know the hiring announcement highlighted that part of your background.
We have a development department that drives the acquisitions, de novo development and health system-relationship developments.
But yes, in my background in the behavioral and dental spaces, I’ve done a lot of de novo and M&A activity – over 100 deals (close to 250). I’m a field operator by nature – that’s who I am.
But I’ve been exposed to a lot of de novo strategy in the ASC world. That really ramped up in the autism and dental businesses I’ve been in. I have a unique lens. I like to say I’m a growth-oriented operator, and I understand the dynamics of de novos and acquisitions, so I’m excited to partner with our development team to help grow the company.
As a field operator, what are the keys for ASCs to position themselves for higher-acuity care shifts? What does an ASC company need to be thinking about?
Our organization is very focused on total joints and spine. We’re also developing cardiovascular centers, which are as high-acuity as you can imagine. I like to think we’re at the forefront of that.
Those procedures are the next wave coming out of inpatient, and we’ve built the expertise to handle them. Whether through acquisitions or de novos, we’re ready to build out centers for those cases.
I would add that the secret sauce to that higher-acuity focus is having fantastic nurse leaders who have been nurses, administrators. You also need the physician alignment. We have the right specialists in place.
The hiring announcement for you described this as a transformative time for ASC joint ventures. Why is this such an exciting moment?
It’s the patient-centric environment and movement.
Everything we do is not a high-acuity case. We do lower-acuity cases, too. If you’re going to go get a colonoscopy, you don’t want to go to the main OR in a hospital. Patients want convenience, like getting a colonoscopy at a center down the street – park, go in for a few hours, and you’re done. It’s very convenient.
For any incoming C-suite leader, it takes time to get settled. What are your strategic priorities as you get started?
Well, just for context, my first couple of weeks were pretty heavy on orientation and listening.
I think, more than anything, I’m looking to understand and listen. I want to figure out what the company is doing really well. Then, I want to explore whether there are areas that can be improved upon. Working through all that takes time.
One of our goals is to grow, right? We have to build the infrastructure that can handle that growth, whether we’re talking about people, processes or systems. Over time, we’ve got to have talented people with the right systems and procedures that are scalable, that are standardized as much as possible.
That’s kind of how I see my early priorities. I don’t think that’ll really change. It’ll just be an evolution of always trying to make sure that we are doing everything to the best of our ability in the most efficient way possible.
Looking at 2026, any bold predictions (for either the industry at large or Compass, specifically)?
Outpatient joint ventures will continue to accelerate and will outpace hospital M&A. Into the future, you’ll see far more transactions and joint ventures around outpatient care.
You’ll also see outpatient development outpacing big acute care hospitals being built.
Is there anything else you’d want readers to know about Compass or your priorities as CEO?
There’s a saying: no margin, no mission. You need a sustainable environment where you can reinvest in the business and employees.
And we’re very patient-centric and physician-centric. If you take care of providers and patients, success will follow. That’s our key focus.
