Gastroenterology in ASCs: 10 Fast Facts

1)    Gastroenterology remains the number one single specialty for procedures in ASCs by volume.

2)    It is one of the top three specialties in ASCs.  The other two types of specialties are orthopedics and ophthalmology.
3)    Nearly 54 percent of all ASCs are single specialty surgery centers. (See SDI's 2008 Outpatient Surgery Center Market Report.)
4)    The largest single type of single-specialty surgery center remains GI centers. Nearly 25-30 percent of all single-specialty centers are GI-specific centers. (See SDI's 2008 Outpatient Surgery Center Market Report.)
5)    This means that there are nearly 700-800 GI surgery centers in the country.
6)    A typical GI case may include 1.2-1.4 procedures per case.
7)    The medium reimbursement is $750-$800 per case. This includes an average of more than one procedure per case.
8)    The average differential between commercial reimbursement and Medicare reimbursement is probably $200-$300 per procedure. We see GI practices, particularly those with four to five or less physicians, having increased trouble retaining all physicians. The loss of certain physicians, due to retirement, relocation or other factors, can substantially reduce the profitability of such centers and increases the cost per procedure for such centers and the overhead cost per physician for the practices.
9)    We continue to see increased efforts by GI practices attempting to profit from anesthesia and from pathology. Each of these efforts has very substantial legal issues attached to it.
10)    It remains generally a buyer’s market for the acquisition of endoscopy surgery centers. At the current rate, prices are gravitating to a 5.5-6.5 EBITDA range with a relatively shallow pool of overall buyers.

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