Hamilton leads 19 deals for national doctor-owned management services organization

In his role at Allied OMS LLC, a doctor-owned and -led management services organization, Brian Hamilton traveled more than 40 weeks out of the year in 2022.

In his time on the road away from his home office in Grand Rapids, Hamilton secured deals with 19 oral and maxillofacial surgical practices, spanning from Oregon in the west to New York in the east and “anywhere and everywhere” in between.

“We had a lot of success,” said Hamilton, the chief development officer at Southlake, Texas-based Allied OMS that formed in July 2020 and has been partnering with maxillofacial surgical practices around the country.

Allied OMS enlists practices and supports their business operations, handling functions such as procurement and contracts with insurers. The firm offers oral and maxillofacial surgical practices a “Doctor Equity” model that’s an alternative to selling to traditional private equity or a health system for groups that want a partner that can support the business and provide growth capital.

“We start to take those things off the plate of the doctor. They can focus on patient care,” Hamilton said. “We remove some of the burden of running a practice, kind of the business side of the business, if you will.”

Practices do not pay to join Allied OMS and “no money changes hands” up front. They instead share a portion of the profits when they subsequently sell after growing and improving profitability with Allied OMS’s backing.

“If all of our practices have grown their EBITDA, they’re going to get more value for their practice” when they ultimately sell three to five years later, Hamilton said. Practices already aligned with Allied OMS have grown their profitability 20 percent in the last year, he said.

Judges selected Hamilton as the winner of the 2023 MiBiz Dealmaker of the Year Award in the executive category in recognition of the volume of partnerships he worked to close in 2022.

Hamilton connected with Allied OMS from his prior work with firm founder and CEO Dan Hosler. They previously worked together at Blue Sky Vision LLC, a private equity-backed group formed from the 2017 acquisition of the former Grand Rapids Ophthalmology by Chicago-based Sterling Partners. At the time, Hosler was senior vice president of strategy at Sterling Partners.

Hosler credits Hamilton with successfully closing nine partnerships with ophthalmologists and optometrists from 2017 to 2019 and guiding Blue Sky Vision to a 2021 merger with Eyecare Partners LLC, the largest eyecare group in the country.

Hamilton joined Allied OMS in 2021 as senior vice president of partnerships and was promoted to chief development officer in late 2022.

Working alongside a business development associate, Hamilton over the course of 2022 helped Allied OMS to more than double the states where it partners with practices and more than triple partnerships from eight to 27.

“Brian has a unique skill set as a business advisor in his ability to quickly build trust among practice owners and to have the difficult conversations required for an owner to ensure they make the right decision around partnership,” Hosler said in submitted comments. “Over the years, Brian has closed more partnerships and has mastered sharing his deep knowledge of health care private equity with doctor partners.”

Hamilton expects Allied OMS to sign two more partnerships with oral and maxillofacial surgical practices that are “at the finish line.” Allied OMS also has a “strong pipeline” for 2023, he said.

New partnerships often originate from referrals from physicians at practices already aligned with Allied OMS, or from meetings at professional conferences or trade shows. Allied OMS does not place any time constraints or deadline on a practice once they start talking, allowing doctors to take their time to consider joining Allied OMS and wait until they’re ready to act, Hamilton said.

“I would say 90 to 120 days from the initial conversation somebody could join, so it can be quick. However, in some cases the timing doesn’t make sense, so it gets delayed,” he said. “There is definitely some work on the front end, but we feel it makes sense from the relationship building.”

When engaging a practice in a conversation about a possible partnership, he’ll often bring in doctors who have already aligned with Allied OMS and can talk peer to peer, rather than “doctors talking to Brian.” That has “allowed us to have a lot more really good conversations that have resulted in groups joining,” he said.

In recruiting practices to align with Allied OMS, Hamilton works to assure physicians that they will retain all operational control, as well as control over all patient treatment planning and clinical processes and protocols. He cites that strategy as a best practice in convincing practices to align with Allied OMS.

“We don’t have a say in how they do those things,” he said. “That tends to be the first issue with private equity or a hospital. Someone starts to dictate how they see patients or how many patients they see in an hour, a week, or whatever. We don’t do any of that.”

Allied OMS’s approach focuses on examining a practice’s business and non-patient operations for improvements that can increase profitability and value.

The success in signing new partnerships in 2022 stemmed in part from an increase in competition among acquirers “that are doing something similar,” such as private equity-backed groups buying medical practices, particularly specialty care providers.

As prospective acquirers reach out to practices in oral and maxillofacial surgery, “it piques their interest” about selling or forming a partnership with somebody, Hamilton said. Allied OMS takes a different strategy that allows physicians to retain their equity in the practice, which resonates with physicians when they explore their options and hear about Allied OMS’s partnership model, he said.

“Everybody else that’s spending marketing dollars (to appeal to practices) has helped us,” Hamilton said.