How to turn ASC staffing from a cost-center into a value center — 8 key steps

Jessica NantzStaffing is consistently among the biggest costs for ambulatory surgery centers.

However, it doesn't necessarily need to over-burden the ASC's financial resources. There are strategies for ASC owners and operators to turn staffing from a cost-center into a value-center.

"As ASCs continue to face growing reimbursement pressures and competition for physicians and patient referrals, administrators are focusing more on expense management to improve profitability of the ASC," says Jessica Nantz, president of Outpatient Healthcare Strategies. "Full-time salaries are, on average, the largest expense items as a percentage of net revenue."

Industry benchmarks show employee salary and wages are typically 22 percent to 24 percent of net revenue, and the amount ASCs spend on staff increases when the center opts for a comprehensive health insurance plan and establishes a bonus structure. Adding new staff is also costly for training, licensing, education and IT considerations for the new position.

"Staffing efficiently and effectively has a material impact on the profitability of an ASC, with cost savings falling to the bottom line," says Ms. Nantz. Here are her key steps to limit staffing costs:

1. Use benchmarking data to develop operational strategies to control large expense items. "It is important to measure staffing costs to determine if the ASC is operating efficiently," she says. "Since staffing is a mix of fixed and variable costs, rather than a static measure, benchmarking is an effective way to assess the center."

2. Take a collaborative approach to benchmarking. "Explain the benchmarks and job responsibilities that must be addressed, and work with your team to develop a staffing pattern that should project to exceed your center's benchmarks and therefore lower your costs," says Ms. Nantz.

3. Use pro re nata staff when it's appropriate to fill openings. "The best staffing models in the industry have fewer full-time core team members with a good mix of experienced PRN staff to ensure staffing is designed to meet the demands of the schedule, not a routine," says Ms. Nantz.

4. Cross-train employees so team members can fill in on slow days or when another member is out of the office, especially for an extended leave of absence. "When you hire staff, set clear expectations about the team culture, work ethic and cross-training," she says. "Downtime in an ASC should be non-existent."

5. Send staff members home early on slow days to limit overtime so you have room to keep them late on busier days. "This expectation should be clearly established," says Ms. Nantz. "In the event there is an opening in the schedule, leadership should make sure staff are using this time productively to work on other projects, such as quality improvement studies, in-services, updating physician preference cards and even 'chores' such as cleaning and reorganizing storage closets."

6. Invest in electronic systems to reduce man hours spent on automated tasks. The center can also outsource tasks to lower the overall staffing expenses.

7. Beyond limiting staffing costs, it's also important to create a culture where full-time staff assists with quality, infection control, risk management and safety requirements. You can use software to track productivity and then establish higher benchmarks or identify areas for improvement.

8. Engage staff members by celebrating their accomplishments inside and outside the ASC. "When staff members believe leadership values and appreciates their contributions, they are more likely to view their jobs less as work and more as opportunity to positively impact the lives of patients, physicians and fellow team members," says Ms. Nantz.

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