More than 40 years ago, three entrepreneurs formed a company to manage and expand Nashville’s Parkview Hospital. As that small venture, Hospital Corp. of America, grew to become the largest for-profit operator of hospitals in the nation, it served as training ground for many of the entrepreneurs and leaders whose efforts have built and continue to fuel the $30 billion economic engine that is Nashville’s health care industry.

To recognize those individuals who influence and propel Nashville’s health care machine, Nashville Post magazine’s sister publication Nashville Medical News released InCharge Healthcare last July. The comprehensive guide of key decision-makers was formed after carefully trimming an extensive list of health care leaders to identify those who are helping to drive local innovation and shape the next iteration of the industry.

In just the six months since the publication of InCharge, those among its ranks have been involved in deals and decisions that have created jobs, relocated companies and expanded the scope and influence of Nashville’s health care sector. Here is a look at the recent work of three such individuals and their growing organizations.

David Black, President & CEO of Aegis Sciences Corp.

Aegis Sciences Corp. recently received the first significant capital infusion in its 20-year history. Now the company is looking for growth.

In October, New York private-equity firm Metalmark Capital took a majority stake in the Nashville laboratory business. Though Aegis CEO Dr. David Black won’t name a dollar amount, he says the capital should sustain the firm’s growth curve and help it pursue expansion strategies that were previously out of its reach.

“We now have the financial resources necessary to continue to grow at a very rapid pace and gather additional market share,” Black said. “We can now consider and engage in acquisitions, which is an area we did not have an opportunity prior to this transaction, and we have the opportunity to consider moving into new market segments.”

Currently, the forensic sciences company employs 370 workers in 15 states and provides toxicology services nationwide to pain management physicians, professional sports leagues and collegiate sports teams, medical examiners’ offices, state and local government agencies, courts of law and Fortune 500 companies.

Black, an internationally recognized forensic toxicologist, formed the company in 1986 as Vanderbilt’s anti-doping lab before incorporating the business four years later. Still today, it’s the firm’s sports testing roots for which Aegis is best known. In fact, it made national news in 2009 when it was running the NASCAR drug screening program that found driver Jeremy Mayfield had tested positive for methamphetamine. And Black, an internationally recognized forensic toxicologist, often serves as an expert witness in court cases involving drug use and testing.

In addition to sports anti-doping work, Aegis also provides workplace drug testing, food and supplement testing and post-mortem toxicology services. But Black says the company’s pain management segment is now its primary growth engine.

The pain management business helps physicians monitor patients who are taking prescription medication for chronic pain to make sure they’re compliant with dosing levels and not mixing medications. The 2006 launch of that segment turned the company’s steady growth into substantial growth, Black says. Pain management now accounts for more than 70 percent of Aegis’ business.

Metalmark Managing Director Fazle Husain said in announcing the firm’s investment that Metalmark believes Aegis provides “the foremost comprehensive prescription drug monitoring program to physicians practicing in the pain management field.” Husain said his firm supports the efforts of Aegis to continue growing in its core markets.

Metalmark and its related Morgan Stanley Capital Partners funds have invested $7 billion of equity capital in more than 100 companies since 1986. With Metalmark’s backing, Black said, the company is first focusing on continued expansion within current market segments. To that end, it will be pushing to win market share from competitors or acquire share by purchasing those rival companies.

“We think that more likely than not the first steps we’d take would be acquisitions within our current market segments,” Black says.

But as Aegis looks to the future, it will also consider acquisitions for new services or technologies that can help it enter new vertical markets. Exactly what those verticals might be, Black isn’t sure — or he isn’t saying.

“The way business is, we might have an opportunity put in front of us tomorrow that we haven’t even thought of,” Black said.

Herb Fritch, Chairman & CEO of HealthSpring Inc.

With a major acquisition and 300-local-job expansion plan, Herb Fritch’s Medicare Advantage plan provider HealthSpring gave Nashville a double dose of big development news in the last half of 2010.

The former — a $545 million deal to buy Baltimore-based competitor Bravo Health — is by far the largest transaction in the company’s 10-year history. Announced in August and closed in November, the deal grows HealthSpring’s revenue by 55 percent and creates the largest company in the country focused exclusively on the Medicare Advantage market.

The acquisition is beneficial to HealthSpring in several ways.

First, there’s the obvious — immediate earnings growth. HealthSpring expects to have a 45 cents to 55 cents per share earnings boost in 2011 thanks to the Bravo deal. In addition, the acquisition moves the company into many new markets, particularly northeastern states of Delaware, Maryland, New Jersey and Pennsylvania.

HealthSpring’s Medicare Advantage plan membership jumps from 200,000 to 300,000 with the deal, and its Medicare Part D membership ranks essentially double, reaching more than 800,000. And HealthSpring plans to build even greater membership in Bravo’s plans through the introduction of physician alignment strategies to those new markets.

At the time the deal was announced, Fritch said he couldn’t think of a better way to “demonstrate our commitment to Medicare Advantage and our confidence in the long-term future of the program” than the Bravo transaction.

“With diversified geography and increased membership scale, the combined companies will be even better positioned in the new environment created by health insurance reform,” Fritch said.

Fritch created HealthSpring in 2000 after buying a controlling interest in a struggling Nashville health plan. The managed care veteran then changed the company’s name and began cobbling together plans in Tennessee, Alabama and Texas before making a $335 million entry into Florida with the purchase of Leon Medical Centers.

Of late, the company has been on a growth tear. Between 2006 and 2009, HealthSpring’s annual revenue has more than doubled, and it was on track to reach up to $3 billion in top-line takings for 2010 as of this writing. Investors, too, have noticed of the company’s performance, helping to boost HealthSpring’s share price by more than 60 percent in 2010.

It’s that organic growth that prompted Fritch’s firm to break ground on a $53 million consolidation and expansion project in MetroCenter in November. The 98,000-square-foot building will let HealthSpring combine the operations of two existing office buildings into one location and make room for it to hire up to 315 additional workers.

HealthSpring’s plans for the project came to light in mid-August, just weeks before it struck the Bravo deal. At the time, HealthSpring Senior VP and Treasurer Lankford Wade said the MetroCenter construction project was unrelated to the acquisition and part of HealthSpring’s “regular growth.”

Company President Mike Mirt echoed Wade in a recent conversation with Nashville Post, adding that the company had been looking into this expansion for two years or “maybe even longer,” and would have moved on the development regardless of the Bravo acquisition.

Mirt admitted, however, that the company may relocate some Bravo employees to the new space in Nashville when it becomes available next September.

C. Wright Pinson, Deputy Vice Chancellor for Health Affairs and CEO of The Hospitals & Clinics at Vanderbilt University Medical Center

Vanderbilt University Medical Center’s transformation of the 100 Oaks Mall into a bustling nexus of health care clinics was C. Wright Pinson’s pet project. The deputy vice chancellor for health affairs managed nearly every aspect of the planning and execution required for the $99 million, multi-year transformation of the blighted mall, from shopping the land to deciding which clinics would move there.

Pinson, who oversees all of VUMC’s clinical operations, is now leading a similar charge into Williamson County.

In October, the academic medical center purchased a plot of land near Williamson Medical Center in Franklin on which it plans to build an outpatient medical office complex. The development could eventually total 500,000 square feet and cost $200 million.

But when news of the $5.1 million, 22-acre land deal broke, Pinson was quick to point out the very preliminary nature of the plans.

“We’re currently just finishing purchasing this property,” he said at the time. “So we have not actually gotten very far down in the program development planning statements. We are busy right now trying to figure out exactly who’s going to go in there and what they’re going to need.”

Pinson, a transplant surgeon by training, was recruited to Vanderbilt as a professor of surgery to start its liver transplant program and liver surgery division in 1990. In the two years prior, he had started the first liver transplantation program in the Pacific Northwest at Oregon Health Sciences University and the first such program in the Veterans Affairs system.

Pinson came to his current post by way of progressive promotions during his time on Vanderbilt’s faculty, recently taking on more responsibility as part of the leadership team put in place in 2009 by new Associate Vice Chancellor for Health Affairs Jeff Balser.

Pinson said the Williamson County development will start at 200,000 square feet and cost about $60 million, opening by 2014. And unlike the project’s 100 Oaks predecessor — which at 440,000 square feet was necessary to alleviate space constraints at Vanderbilt’s main Nashville campus — the Williamson County project is one of convenience. Vanderbilt has some 130 health care providers and 550 employees spread across 15 different leases for some 225,000 square feet in Williamson County. This development should consolidate half of those offices under one roof, helping VUMC better manage its Franklin facilities and costs.

But given VUMC’s relatively slow practice growth in Williamson County, it would be another “10 to 15 years before we would get to 500,000 [square feet],” Pinson said.

In the meantime, the office project has the potential to spark development on the Carothers Parkway corridor similar to the resurgence of retail and restaurants that has occurred near Vanderbilt Health 100 Oaks. In fact, Pinson said the project could be the first step toward making the Carothers Parkway route between the county hospital and VUMC’s new facility the “the medical corridor of Cool Springs.”

For now, though, all we can do is wait and watch. VUMC and Pinson have been mum on any Cool Springs decisions since the land purchase in October.