10 Trends in ASC Pain Management Case Revenue Based on Facility Size From 2007-2010

Here are 10 trends on pain management case revenue based on number of operating rooms, case volume and facility revenue from 2007-2010 using data from VMG Health's Multi-Specialty ASC Intellimarker reports from 2008-2011. (Note: Data in the reports are from the previous calendar year.)

The trends seem to imply that the bigger a center's operations, the higher the net revenue and gross charges. This wasn't always the case, however. Up until 2008/2009, centers with fewer operating room and fewer procedures had higher gross charges and net revenue. A higher center net revenue was indicative of higher net revenue per case throughout the four years.

1. Starting in 2008, the more ORs an ASC operated, the higher the gross charges. In 2007, the fewer ORs a center operated, the higher the gross charges. Centers with one or two ORs had average gross charges of $2,772, while centers that operated more than four ORs had average gross charges of $2,617. Starting in 2008, centers operating more than four ORs had the highest gross charges — and the margin has increased every year. In 2010, centers with more than four ORs charged almost $1,000 more than their counterparts with three or four ORs.

2. Starting in 2009, the more ORs an ASC operated, the higher the net revenue. The year after this change occurred with gross charges, net revenue saw the same transformation. Up until 2009, the fewer operating rooms, the higher the net revenue. The margin shrank from $134 in 2007 to $37 2008 and flipped by 2009. In 2009, centers with more than four ORs charged $402 more than ASCs with one or two ORs. That margin decreased to $267 in 2010.

3. ASCs operating one to two ORs saw a large decrease in gross charges and net revenue from 2008-2009. In 2008, ASCs with one to two ORs had gross charges of $3,259, but that dropped to $2,700 in 2009. The decrease was even more marked when looking at net revenue. In 2008, ASCs with one to two ORs had the highest net revenues at $919, but that nearly halved to $588 in 2009.

4. ASCs with more than four ORs have seen increased in gross charges and net revenue every year. Centers operating more than four ORs have seen an increase in both gross charges and net revenues each year, and they were the only group to do that. Gross charges increased an average of about $700 each year, while net revenue increased an average of about $100 each year.

5. ASCs performing fewer than 3,000 procedures had the highest gross charges and net revenue until 2010. Up until 2010, center performing less than 3,000 procedures per year had the highest gross charges and net revenue. Starting in that year, ASCs doing more than 6,000 procedures a year had the highest gross charges and net revenue per case. In 2010, centers performing more than 6,000 procedures had gross charges about $400 higher than centers doing fewer than 3,000. That same year, ASCs performing more than 6,000 procedures had an average net revenue more than $200 higher than centers performing fewer than 3,000 procedures.

6. There was a big increase in gross charges for all size centers between 2007 and 2008. Between 2007 and 2008, centers of all sizes saw gross charges increase an average of more than $1,400: $2,117 for centers performing fewer than 3,000 procedures, $741 for centers performing 3,000-6,000 and $1431 for centers performing more than 6,000.

7. ASCs performing more than 6,000 procedures saw increased in gross charges and net revenue every year.
ASCs performing more than 6,000 procedures a year saw an increase in both gross charges and net revenue each year; they were they only group to do so. Gross charges increased an average of about $700 each year, while net revenue increased an average of about $70 each year.

8. ASCs with more than $7 million in revenue had the highest net revenue per case every year. ASCs with more than $7 million in revenue had the highest net revenue per case and were the only ones to see an increase in net revenue each year, averaging $94 per year. The margin was the biggest in 2010 when ASCs with more than $7 million in revenue had revenues of more than $350 more than the two other groups.

9. ASCs with less than $4.5 million in revenue had the lowest net revenue per case every year. ASCs with less than $4.5 million in revenue had the lowest net revenue per case every year from 2007-2010. The disparity between these centers and centers with more than $7 million in revenue has been increasing every year. In 2007, the disparity was only $85; in 2010, it was $442.

10. ASCs with more than $7 million in revenue were the only group with higher net revenue in 2010 than in 2007.
According to the data, centers with more than $7 million in revenue were the only centers with higher net revenue in 2010 than in 2007. These centers showed an increase of $283 while center with revenues of $4.5 million-7 million showed a decrease of $59 and centers with revenues less than $4.5 million showed a decrease of $74.

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