110 ASC benchmarks & statistics to know — 2016

ASCs are an important aspect of healthcare going forward and there are continued opportunities for ASCs to improve quality while decreasing costs.

ASCs can save commercial insurance providers and their beneficiaries $38 billion each year as an alternative to hospital outpatient departments for outpatient surgical care. Patients save more than $5 billion personally due to lower deductibles and co-insurance payments while the average savings per person is $183 based on the average commercial ASC-eligible spend per person per year of $890.

The average savings ASCs have for Medicare is $2.3 billion as an alternative to hospital outpatient departments for outpatient surgical care. The centers can save Medicare beneficiaries $1.5 billion personally due to lower copayments.

Here are 110 operational, financial and quality benchmarks for ASCs to know.

Staffing benchmarks

The following statistics come from the OR Manager 2016 Salary/Career Survey focused on ambulatory surgery centers. The survey was posted in September 2016.

• Average administrator salary: $104,721 (compared with $102,051 in 2015)
• Average total administrator compensation: $128,112 (compared with $130,000 in 2015)
• Average hours worked in a week: 48.2 hours
• Reporting higher case volume in 2016 than 2015: 56 percent
• Reporting lower volume in 2016 than 2015: 11 percent
• Satisfied with their jobs: 80 percent
• Average raise: 3.39 percent (compared to 3 percent in 2015)
• Profit sharing: 61 percent
• Plan to stay with current employer until retirement: 61 percent
• Plan to retire by 2020: 25 percent
• Difference from hospital counterparts: ASC managers made $9,927 less (compared to $13,935 less in 2015)

The following statistics come from the Ambulatory Surgery Center Association’s 2015 ASC Salary and Benefits Survey report. There were 846 participants in the survey covering 20 ASC job positions, employee benefits and ASC demographics. Most — 95 percent — of the respondents reported physicians in their ownership mix. The ASCs also had been in business for an average of 12 years, had 19 full-time employees and reported little more than 3,700 annual cases. The majority were located in suburban areas.

Benefits

• Health insurance to employees: 97 percent
• Family health insurance: 9 percent
• Vision insurance: 8 percent
• Life insurance: 6 percent
• Retirement benefits: 94 percent

Salaries (increase from 2012 to 2015)

• Administrator: 5 percent
• Director of nursing: 6 percent
• Office manager: 5 percent
• Materials manager: 9 percent

Bonuses available to staff

• Administrators: 84 percent (up from 69 percent in 2012)
• Head of nursing staff: 74 percent (up from 60 percent in 2012)
• Business office manager: 73 percent (up from 61 percent in 2012)
• Materials manager: 63 percent (up from 47 percent in 2012)

Bonus amounts (decrease from 2012)

• Business office manager: More than 25 percent
• Materials manager: More than 25 percent
• Director of nursing: 10 percent
• Administrator: 3 percent

CASC credential

• Required for administrator position: 14 percent of ASCs
• Median salary for administrators at CASC-required centers is 19 percent higher than at ASCs where the credential is not required

Quality reporting

This data is based on the ASC Quality Collaboration Quality Report from the first quarter of 2016. There were 1,516 ASCs participating, representing more than 1.8 million admissions. The data was collected Jan. 1, 2016 through March 31, 2016. There were 999 multispecialty ASCs and 528 single specialty ASCs from all 50 states. However, not all ASCs provided data for each quality measure.

• Patient fall rate per 1,000 ASC admissions: 0.123
• Patient burn rate per 1,000 ASC admissions: 0.016
• Hospital transfers/admissions per 1,000 ASC admissions: 1.067
• Rate of wrong site, side, patient, procedure, implant per 1,000 ASC admissions: 0.028
• Percentage of ASC admissions with antibiotic ordered who received antibiotic on time: 99 percent
• Percentage of ASC admissions with appropriate surgical site hair removal: 96 percent
• Percentage of eligible ASC patients with normothermia: 97 percent
• Percentage of ASC cataract patients with unplanned anterior vitrectomy: 0.5 percent

Revenue cycle

The following benchmarks are from Regent RCM based on best-in-class performers called the Regent RCM Gold Standard.

• Days outstanding: 30 days
• % A/R over 90 days: 12 percent
• Charge lag (date-of-service to charge entry): less than 3 days
• Statements lag (date a balance becomes a patient’s responsibility to time the statement is sent): 5 days
• Denials: less than 5 percent
• Clean claim rate: 98 percent
• Net collection rate (how much collected of the contractual amount): 97 percent
• Staffing FTEs per 1,000 cases: 1.5 FTEs in 2014 (dropped from 1.85 FTEs in 2010)

Operational

The following ASC salary and benefits statistics are from the "HealthCare Appraisers 2016 ASC Valuation Survey: How do the ASC companies assess value?" that includes responses from 20 ASC companies representing more than 700 surgery centers throughout the United States. The centers include only those that are in-network.

Salary and benefits

• 10 percent to 19.9 percent of revenue: 12 percent of respondents
• 20 percent to 29.9 percent of revenue: 65 percent of respondents
• 30 percent to 39 percent of revenue: 24 percent of respondents

Occupancy

• 0 percent to 9.9 percent of revenue: 50 percent of respondents
• 10 percent to 19.9 percent of revenue: 38 percent
• 20 percent to 29.9 percent of revenue: 13 percent

Drug, medical supplies and implantables

• 10 percent to 19.9 percent of revenue: 19 percent
• 20 percent to 29.9 percent of revenue: 62 percent
• 30 percent to 39.9 percent of revenue: 19 percent

Specialty

The following benchmarks are from the AAAHC based on clinical studies.

Cataract surgery

Benchmarking study from AAAHC based on clinical studies of cataract extraction surgeries with lens insertions between January and June 2016. The study includes 78 organizations with a combined 161,223 cataract surgeries per year.

• Pre-procedure time: 81 minutes
• Procedure time: 13 minutes
• Discharge time: 20 minutes
• Patients waiting less than one month between scheduling and surgery: 77 percent
• Patients resuming daily activity within one week: 95 percent
• Comfortable undergoing cataract surgery at an ASC: 99 percent

Colonoscopy

Benchmarking study from AAAHC on clinical findings for colonoscopy from 49 organizations performing 203,202 colonoscopies between January and June 2016.
• Pre-procedure time: 11 minutes to 98 minutes from check-in to scope insertion
• Procedure time: 10 minutes to 27 minutes
• Discharge time: 6 minutes to 80 minutes
• Patients reporting minimal or no discomfort during bowel preparation: 71 percent
• Patients waiting less than one month between scheduling and undergoing procedure: 76 percent
• Patients comfortable after discharge: 98 percent

Esophagogastroduodenoscopy

• Pre-procedure time: 19 minutes to 118 minutes
• Procedure time: 3 minutes to 18 minutes
• Discharge time: 16 minutes to 72 minutes
• Patients that report little or no discomfort during the procedure and would recommend to others: 98 percent

Knee arthroscopy

Benchmarking study from AAAHC on clinical findings for knee arthroscopy in the ASC based on data from 8 organizations that perform a combined total of 2,519 knee arthroscopies annually. The study was conducted between January and June 2016.

• Pre-procedure time: 81 minutes
• Procedure time: 20 minutes
• Discharge time: 67 minutes
• Patients that wait less than one month for their procedure after scheduling: 83 percent
• Patients who are comfortable post-discharge: 99 percent

Shoulder arthroscopy

Benchmarking study from AAAHC on clinical findings for shoulder arthroscopy in the ASC based on data from 10 organizations that perform a combined total of 4,173 shoulder arthroscopies annually. The study was conducted between January and June 2016.

• Pre-procedure time: 123 minutes
• Procedure time: 57 minutes
• Discharge time: 90 minutes
• Patients waiting less than one month from scheduling to surgery: 68 percent
• Patients comfortable post-discharge in the ASC: 98 percent

Low back pain

Benchmarking study from AAAHC on clinical findings for low back pain in ambulatory care settings based on data from 42 organizations that perform a combined total of more than 89,175 low back injections annually. The data was collected between January and June 2016.

• Pre-procedure time: 42 minutes
• Procedure time: 7 minutes
• Discharge time: 22 minutes
• Patients waiting less than one month from scheduling the procedure to surgery: 92 percent
• Patients returning to daily activities after injection: 85 percent
• Patients reporting less pain after low back pain injections: 77 percent
• Patients who reduced pain medications after the procedure: 51 percent

Case volume & revenue

The following statistics are based on VMG Health’s Intellimarker Ambulatory Surgical Centers Financial & Operational Benchmarking Study 2012 report. The study includes an analysis of more than 201 licensed freestanding ASC covering more than 1 million cases.

Case volume mix as a percentage of total cases

• ENT: 9 percent
• GI/Endoscopy: 27 percent
• General surgery: 7 percent
• OB/GYN: 3 percent
• Ophthalmology: 17 percent
• Oral surgery: 1 percent
• Orthopedics: 17 percent
• Pain management: 13 percent
• Plastic: 4 percent
• Podiatry: 3 percent
• Urology: 2 percent

Net revenue per case

• ENT: $1,849
• GI/Endoscopy: $788
• General surgery: $1,795
• OB/GYN: $2,081
• Ophthalmology: $1,273
• Oral surgery: $1,026
• Orthopedics: $2,618
• Pain management: $840
• Plastic: $1,696
• Podiatry: $1,893
• Urology: $1,788

More articles on surgery centers:
5 things ASCs can do to thrive in the value-based world
The complexities of properly staffing your ASC's business office
5 key thoughts on ASCs navigating TJR reimbursement with commercial payers

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