Investment firm Ortelius Advisors delivered an open letter to Surgery Partners Inc. (NASDAQ: SGRY) stockholders criticizing the company's leadership and stock performance while proposing strategic changes including asset sales and management restructuring.

According to the March 10 letter, Surgery Partners' stock price declined 67% over the past five years, underperforming market benchmarks by 108 percentage points on average. The company also lagged behind healthcare peers HCA Healthcare and Tenet Healthcare Corporation by 276 and 413 percentage points respectively over the five-year period.

Ortelius presented comparative performance data showing Surgery Partners posted negative returns of 45% over one year, 58% over three years, and 67% over five years, while competitors achieved substantial positive returns during the same periods.

The investment firm outlined several proposals for value creation, including divesting all surgical hospitals to generate asset sale proceeds for stock repurchases and debt reduction. Ortelius stated this would create a pure-play ambulatory surgery centers business with stronger growth metrics and higher margins.

Additional recommendations include board refreshment, management team changes, and a review of strategic alternatives. The letter characterized Surgery Partners' results across strategy, operations, and financial management as "unacceptable."

Ortelius described itself as a research-intensive, fundamental-based, activist-oriented alternative investment management firm focused on event-driven opportunities. The firm's managing member Peter DeSorcy signed the letter to stockholders.