Orthopedics, along with ophthalmology and gastroenterology, is one of the top three ASC specialties. Here are 15 things to know.
1. Case volume for orthopedics in ASCs ranges from 16 percent to 20 percent. Here are four statistics on orthopedics case volume in ASCs from the VMG Health Multi-Specialty ASC Intellimarker Study.
All facilities: 17 percent
Less than 3,000 procedures: 20 percent
3,000 to 5,999 procedures: 16 percent
6,000 or more procedures: 17 percent
The study includes the analysis of more than 201 freestanding ASCs across the United States.
2. Net revenue per case for orthopedic cases in ASCs can reach nearly $5,000; however gross charges near $13,000. Here are the gross charges and net revenue per case as well as discount to charges for orthopedic cases at ASCs, according to the VMG Health report:
Gross charges per case:
Average: $9,289
Bottom 25 percent: $7,659
Top 10 percent: $12,487
Net revenue per case:
Average: $3,190
Bottom 25 percent: $2,335
Top 10 percent: $4,803
Discount to charges:
Average: 62.8 percent
Bottom 25 percent: 55.9 percent
Top 10 percent: 77.7 percent
3. Skilled and expert staff members are essential in any ASC, and particularly orthopedics-focused facilities where both the risk and reward is higher. According to the VMG Health report, here are 12 statistics on staffing at orthopedics-driven ASCs:
Nurse FTE: 13.1
Tech FTE: 5.4
Administrative FTE: 9.3
Administrator FTE: 1
Nurse hours per case: 8.9
Tech hours per case: 3.3
Administrative hours per case: 6.3
Administrator hours per case: 0.7
Nurse staff hourly wage: $32.71
Tech staff hourly wage: $21.40
Administrative staff hourly wage: $24.50
Administrator salary: $126,965
4. Around 50 percent of both urban and rural ASCs provide orthopedics, notes The Impact of Freestanding Surgery Centers on Rural Community Hospital Performance report.
5. Most orthopedics-driven ASCs have a high percentage of commercial payers in their payer mix. Facilities with greater than 50 percent of orthopedic case volume have the following average payer mix, according to the VMG Health study:
• Commercial — 62 percent
• Medicare — 17 percent
• Worker's comp — 11 percent
• Medicaid — 4 percent
• Self pay — 2 percent
• Other pay — 8 percent
6. Orthopedics is regularly ranked as a top-earning specialty. Jackson & Coker's 2015 Physician Salary Calculator shows:
Annual average compensation for full-time orthopedic surgeon:
• National average compensation — $552,696
• Average benefits — $110,539
• Total average compensation — $663,235
• National average gross revenue per provider — $1,960,444
Hourly average compensation for full-time orthopedic surgeon:
• National average compensation — $265
• Average benefits — $53
• Total average compensation — $318
• National average gross revenue per provider — $942
7. Orthopedist net worth is typically in the millions, with 10 percent of orthopedic surgeons reporting net worth more than $5 million. Here five statistics on orthopedic surgeon net worth from Medscape's Physician Debt and Net Worth Report 2015:
• Under $500,000: 21 percent
• $500,000 to $999,999: 16 percent
• $1 million to $1.9 million: 26 percent
• $2 million to $5 million: 27 percent
• Over $5 million: 10 percent
8. The average medical resident salary for orthopedists in 2015 is $54,000, notes Medscape's Residents Salary & Debt Report 2015.
9. Orthopedist pay varies across the country, but only slightly. In accordance with U.S. region, here is orthopedic surgeon compensation:
• Northwest — $460,000
• Great Lakes — $457,000
• Southwest — $456,000
• South Central — $446,000
• Southeast — $432,000
• Mid-Atlantic — $416,000
• North Central — $410,000
• Northeast — $381,000
• West — $333,000
10. There is also slight variation for pay among orthopedic subspecialties. Here is the median compensation for orthopedic subspecialists, according to an American Medical Group Association survey:
• Foot and Ankle — $505,606
• Hand — $513,864
• Pediatrics — $516,544
• Trauma — $540,197
• Sports Medicine — $549,048
• Joint Replacement — $563,896
• Oncology — $569,353
• Spine — $749,445
11. Orthopedics is among the five least popular healthcare specialties by average online ranking, according to a Vanguard Communications report. The study examined 28,000 online physician reviews. Orthopedists have an average rating of 3.59 out of five stars.
12. Orthopedic surgeons perform an average of 29 procedures per month, with full-time orthopedic surgeons performing 32 procedures per month and part-time orthopedists performing six procedures per month, according the 2014 Orthopaedic Surgeon Census by the American Association of Orthopaedic Surgeons.
13. Wyoming, Montana, New Hampshire, Vermont and South Dakota have the highest density of orthopedic surgeons. Mississippi, Texas, Arkansas, West Virginia and Michigan have the lowest surgeon density, notes the AAOS census.
14. A number of hospitals, practices and management and development companies are focusing on establishing orthopedics-driven ASCs. Excelsior Orthopaedics, based in Buffalo, N.Y., has broken ground on its new, $9.5 million ambulatory surgery center in Amherst, N.Y. The facility could be completed as early as January 2016.
Earlier this year, Orthopaedic Institute for Children in Los Angeles is broke ground on a new ASC, which is expected to cost $10 million and span 13,000 square feet.
15. According to Luke Lambert, Ambulatory Surgical Centers of America CEO, specialties like orthopedics and gastroenterology are facing challenges due to referral pattern changes.