110 ASC benchmarks | 2015

Here are 110 ASC benchmarks and statistics for ASCs based on data collected from several industry sources.

Operational

1. Surgical cases per operating room per day — 2.1 to 3.81

2. Non-surgical cases per operating room per day — 1.6 to 5.6

3. Operating room time per case — 40 minutes to 60 minutes

4. Procedure time per case — 30 minutes to 40 minutes

5. RN time per case — 5 hours to 7.2 hours

6. Tech time per case — 1.9 hours to 3.3 hours

7. Administrative time per case — 3.5 hours to 5.7 hours

8. Total staff time per case — 10.4 hours to 16.2 hours

9. Average room turnover — six minutes to 10 minutes

10. Top five physicians (percent of cases) — 50 percent to 80 percent

11. Top 10 physicians (percent of cases) — 60 percent to 85 percent

12. Staff hours per case — 11.0 hours2

13. Administrative hours per case — 4.3 hours

14. Nurse hours per case in one- to two-operating room centers — 6.2 hours

15. Administrative hours at one- to two-OR centers — 3.9 hours

16. Nurse hours at ASCs with three to four ORs — 6.1 hours

17. Administrative hours at ASCs with three to four ORs — 3.8 hours

18. Days in accounts receivable outstanding — 3017

19. Current A/R days — 70 percent

Financial

20. GI/endoscopy revenue per case — $630 to $1,0201

21. General surgery revenue per case — $1,220 to $2,320

22. Orthopedic revenue per case — $1,880 to $3,520

23. Salaries, wages and benefits per case — $270 to $420

24. Debt-to-equity ratio — 18 percent to 132 percent

25. Medical/surgical costs per case — $230 to $465

26. Total operating expenses per case — $805 to$1,520

27. Salaries, wages and benefits as percent of net revenue — 17 percent to 27
percent

28. Supply cost as percent of net revenue — 17 percent to 25 percent

29. Total operating expenses as percent of revenue — 60 percent to 85 percent

30. Cash as days of operating expenses — 30 days to 75 days

31. Cash as percent of total assets — 10 percent to 28 percent

32. Bad debt percentage — 1 percent to 2.8 percent

33. Medicare reimbursement as percent of gross charges — 15 percent to 35
percent

34. Commercial reimbursement as percent of gross charges — 45 percent to 70
percent

35. ASC reimbursement as percent of HOPD reimbursement — 58 percent to 65
percent

36. Gastroenterologist compensation in an outpatient clinic — $275,0003

37. Orthopedist compensation in an outpatient clinic — $190,0004

38. Ophthalmologist compensation in an outpatient clinic — $195,0005

Commercial payer rates

39. Thirty-five percent of ASC management companies observed a 1.0 to 1.9
percent increase8

40. Thirty-five percent of ASC management companies observed a 2.0 to 2.9
percent increase

41. Twenty-five percent of ASC management companies observed a 3.0 to 3.9
percent increase

42. Zero percent of ASC management companies observed a 4.0 to 4.9 percent
increase

43. Five percent of ASC management companies observed a 5.0 to 5.9 percent
increase

Medical supplies and implantable device costs

44. Ten percent of ASC management companies saw less than a 0.9 percent
increase

45. Twenty-five percent of ASC management companies saw a 1.0 to 1.9 percent
increase

46. Thirty percent of ASC management companies saw a 2.0 to 2.9 percent
increase

47. Twenty percent of ASC management companies saw a 3.0 to 3.9 percent
increase

48. Ten percent of ASC management companies saw a 4.0 to 4.9 percent increase

49. Five percent of ASC management companies saw a 5.0 to 5.9 percent increase

ASC staff raises

50. Five percent of ASC management companies experienced a 1.0 to 1.9 percent
increase

51. Seventy-four percent of ASC management companies experienced a 2.0 to 2.9
percent increase

52. Sixteen percent of ASC management companies experienced a 3.0 to 3.9
percent increase

53. Zero percent of ASC management companies experienced a 4.0 to 4.9 percent
increase

54. Five percent of ASC management companies experienced a 5.0 to 5.9 percent
increase

Other ASC expenses

55. Twenty-five percent of ASC management companies observed a 1.0 to 1.9
percent increase

56. Forty percent of ASC management companies observed a 2.0 to 2.9 percent
increase

57. Twenty-five percent ASC management companies observed a 3.0 to 3.9
percent increase

58. Ten percent of ASC management companies observed a 4.0 to 4.9 percent
increase

Safety and quality

59. The rate of patient falls — 0.136 per 1,000 admissions6

60. The rate of patient burns — 0.019 per 1,000 admissions

61. The rate of hospital transfers/admissions — 1.110 per 1,000 admissions

62. The rate of wrong site, side, patient, procedure, implant events — 0.030 per
1,000 admissions

63. The percentage of ASC admissions with antibiotics ordered who received
antibiotics on time — 99 percent

64. The percentage of ASC admissions with appropriate surgical site hair removal
— 95 percent

Management companies

65. Although surgeons face payer issues, 94 percent of ASC management
companies reported orthopedic spine was a desirable specialty.7

66. Approximately 68 percent of ASC management companies have equity
ownership in all freestanding entities they managed.

67. Approximately 25 percent of ASC management companies have 11 to 30
ASCs under ownership. An additional 30 percent have 31 or more ASCs
under ownership.

68. Ninety percent of ASC management companies prefer between six and 15
physician owners for a single-specialty ASC. Eighty-nine percent of
respondents prefer between 11 and 20 physician owners for a multispecialty
ASC.

69. Last year, approximately 38 percent of ASC management companies have
between one to five acquisitions, with 24 percent of the companies acquiring
between six and 10 centers.8

Clinical benchmarks by specialty

Cataract surgery

70. Eight-seven percent of patients waited less than one month between
scheduling and undergoing surgery.9

71. Ninety-five percent of patients scheduled their surgery at their preferred time
in the ASC.

72. Ninety-seven percent of patients resume daily living within one week postop.

73. Ninety-four percent of patients reported enhanced vision after surgery.

74. Ninety-nine percent of patients say they're comfortable during surgery and 99
percent are comfortable after discharge.

75. Ninety-nine percent of patients would recommend cataract surgery in an ASC
following surgery.

76. Pre-procedure time is 82 minutes for cataract surgeries.

77. Procedure time for cataract surgeries in ASCs is 13 minutes.

78. Discharge time for cataract surgeries is 20 minutes.

Colonoscopy

79. Seventy-seven percent of colonoscopy patients report minimal or no
discomfort during bowel preparation.10

80. Seventy-seven percent of colonoscopy patients waited less than one month
between scheduling and undergoing surgery.

81. Ninety-eight percent of colonoscopy patients were comfortable after
discharge.

82. Ninety-nine percent of colonoscopy patients report minimal or no discomfort
during the procedure and would recommend it to others.

83. One hundred percent of colonoscopy patients understood the procedure.

84. Colonoscopy procedure time is 10 minutes to 31 minutes.

85. Pre-procedure time for colonoscopy is 13 minutes to 92 minutes, from patient
check-in to scope insertion.

86. Colonoscopy discharge time is 14 minutes to 66 minutes.

Knee arthroscopy

87. Knee arthroscopy procedure takes 23 minutes.11

88. Discharge time for knee arthroscopy takes 77 minutes.

89. Eighty-five percent of knee arthroscopy patients waited less than one month
between scheduling and undergoing surgery.

90. Ninety-one percent of knee arthroscopy patients scheduled the procedure as
soon as they wanted in the ASC.

91. One hundred percent of knee arthroscopy patients were comfortable postop.

Shoulder arthroscopy

92. Shoulder arthroscopy procedure time takes 59 minutes.12

93. Discharge time for shoulder arthroscopy takes 96 minutes.

94. Seventy-eight percent of shoulder arthroscopy patients waited less than one
month between scheduling and undergoing surgery.

95. Eighty-seven percent of shoulder arthroscopy patients scheduled the
procedure as soon as they wanted in the ASC.

96. Ninety-five percent of shoulder arthroscopy patients were comfortable postop.

Lower Back

97. Procedure time takes six minutes for low back injections.13

98. Discharge time after low back injections takes 24 minutes, with a range of
seven to 64 minutes.

99. Ninety-one percent of patients waited less than one month between scheduling
and undergoing surgery.

100. Ninety-seven percent of patients scheduled their lower back injections within
a "reasonable" period to time.

101. Eighty-eight percent of patients returned to daily activities after undergoing
low back injections.

102. Seventy-six percent of patients reported less pain after the low back
injections.

Spine

103. Total cost of eight nursing hours per patient, factoring in multiple staff in
room — $300 to $35018

104. Average implant costs — $5,000

105. Average annual number of surgeries — 300 to 350

106. Average annual number of pain procedures — 2,000

Supply chain

107. Sixteen percent of physicians are very engaged in supply cost management,
and 39 percent reported being engaged. Only 6 percent reported not being
engaged at all.7

108. ASCs utilize various supply chain strategies, with 34 percent of surgery
centers using product standardization, and an additional 24 percent of centers use group purchasing organization evaluation as a supply chain strategy.

Patient satisfaction

109. ASC leaders reported high levels of satisfaction, with an average job
satisfaction rating of 4.2 out of a 5 point scale. One-third are "very satisfied"
and none are unsatisfied.

110. National average return rate based on patient satisfaction scores — 34
percent15

References
1. Avanza Healthcare Strategies
2. VMG Multispecialty ASC Intellimarker 2012
3. Medscape Gastroenterologist Compensation Report 2015
4. Medscape Orthopedist Compensation Report 2015
5. Medscape Ophthalmologist Compensation Report 2015
6. ASC Quality Collaboration Quality Report 1ssr Quarter 2015
7. 2011 Provista Report of ASC Survey Findings
8. HealthCare Appraisers Valuation 2015 survey
9. Benchmarking study from AAAHC based on clinical studies of cataract extraction surgeries with lens insertions. The study includes 79 organizations with a combined 163,568 cataract surgeries per year.
10. Benchmarking study from AAAHC on clinical findings for colonoscopy from 67 organizations performing 200,232 colonoscopies between January and June 2015.1
11. Benchmarking study from AAAHC on clinical findings for knee arthroscopy in the ASC based on data from 12 organizations that perform a combined total of 2,996 knee arthroscopies annually. The study was conducted between January and June 2015.
12. Benchmarking study from AAAHC on clinical findings for shoulder arthroscopy in the ASC based on data from 24 organizations that perform a combined total of 11,273 shoulder arthroscopies annually. The study was conducted between January and June 2015.
13. Benchmarking study from AAAHC on clinical findings for low back pain in ambulatory care settings based on data from 39 organizations that perform a combined total of more than 47,027 low back injections annually. The data was collected between January and June 2015.
14. Medicare Payment Advisory Commission 2015 data
15. Sasso Consulting
16. Ambulatory Surgery Center Association
17. Ambulatory Surgical Centers of America Benchmarking 2014-2015
18. Benchmark based on data collected from Richard Wohns, MD, of NeoSpine

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