11 Statistics and Processes ASCs Should Track to Improve Efficiency

Reimbursement rates are likely headed down with the government regulating what services are to be provided, how services are to be provided, what will be paid for the work, and — with the emergence of the accountable care organization concept — how providers are to be paid. In this environment it's more important than ever to have a complete understanding of all cost components and how they compare to competing providers and alternative choices. In addition, the cost side will remain an area over which providers can exercise some control, so we all need to find ways to provide services at lower cost. In an ASC the two areas where increased efficiency has the greatest impact on the bottom line are medical supplies and services, and administrative services.

Medical services. Providers need to examine how its resources (i.e., labor time, facility space and quantity of materials and service) are used. Some measures to consider and to manage include:

1. Cases per day. Can we adjust our scheduling to better manage capacity?
2. OR utilization. Are particular operating rooms used more than others? Do we have access to new case sources to fill any down time?
3. Labor hours per case. Even an overview calculation can help providers identify areas ripe for improvement. The more detailed the data, though, the more targeted any corrective actions can be. Are some surgeons more productive than others? Are some employees not performing at an optimum level? Will problems be fixed with training, motivation, or replacement? Can we adjust the employees' schedules to maximize case time and minimize down time? Are there technological improvements that could replace labor at a cost savings?
4. Personnel per case. Do we use too many people? Can we still provide quality outcomes with fewer nurses or support staff?
5. Supplies and pharmaceuticals per case. Can we implement procedures or changes to reduce the quantity of material needed? Can usage be reduced through additional training? Will changing product brand or type lead to any reductions?

Administrative services. Services in payroll, HR, accounting, billing and collecting are more of a fixed nature than medical services. No matter how many cases are performed, the vendors and employees need to be paid, patients need to be billed and money needs to be collected. The key is for managers to be involved with administrative staff to ensure that employees are working at full capacity and full effectiveness. These are also areas where an ASC can benefit from outsourcing; companies (like MedHQ) can flexibly apply its expertise in these areas in such a way that fits the frequency, variability and type of work needed. It can be difficult and expensive for an ASC to hire and manage all the personnel needed to match the level of service an outsourcing company can provide. Whether these functions are outsourced or handled in house, there are some indicators of performance that managers need to monitor:

6. Days in A/R. With increasing government involvement, this will become harder to manage as providers have fewer tools at their disposal to ensure timely collection. Knowing where the trouble spots are can still be strategically helpful, though.
7. Review of aged A/R. Frequent review of the aging should prevent actionable accounts from getting too old. Providers will be able to take steps to collect on actionable accounts while writing off uncollectible accounts to avoid wasted time.
8. Denials. Tracking the frequency of and reason for denials can be helpful in evaluating the efficiency and effectiveness of internal procedures and personnel. It can also highlight areas that need to be addressed directly with the payors.
9. Refunds. This is another measurement that can be used to evaluate internal procedures and personnel.
10. Claims processed per hour. Are billing personnel working at full capacity? Are there tools, such as software, that the ASC can use to improve efficiency?
11. Periodic billing audits. Are we billing for all procedures performed? Are we billing incorrectly?

Learn more about MedHQ.