100 ASC benchmarks to know — 2014

Here are 100 benchmarks and statistics for ambulatory surgery centers based on reports from VMG Health, Avanza Healthcare Strategies, Provista, The Medicare Payment Advisory Commission, RemitData, Accreditation Association for Ambulatory Health Care, ASC Quality Collaborative, HealthCare Appraisers, Objective Health and U.S. Federal Government data.

All benchmarks and statistics on this list are averages gathered by compiling data from multiple ASCs.

Operating expenses

1. Administrator salary is $108,014. 1

2. Administrators in the west and northeast receive the highest salaries, at $109,475 and $109,268 respectively, while administrators in the southeast receive the lowest salary at $102, 332. 1

3. Salaries, wages and benefits are between 17 percent and 27 percent of net revenue. 2

4. Total operating expenses per OR is $1.44 million. 1

5. Employee salary and wages per operating room is $426,020. 1

6. Medical and surgical expenses per OR are $410,500. 1

7. General and administrative expenses per OR are $328,360. 1

8. Total operating expenses as a percent of revenue are between 60 percent and 85 percent. 2

9. Total cash as days of operating expenses is between 30 days and 75 days. 2

10. Cash as a percentage of total assets is between 10 percent and 28 percent of assets. 2

11. Bad debt percentage is between 1 percent and 2.8 percent. 2

12. Days in accounts receivable are between 28 days and 40 days. 2

13. Debt-to-equity ratio is between 18 percent and 132 percent. 2

14. Medicare as a percent of gross charges is between 15 percent and 35 percent. 2

15. Commercial as a percent of gross charges is between 45 percent and 70 percent. 2

Case hours

16. Staff hours per case at ASCs is 11.0 hours. 1

17. Administrative hours per case is 4.3 hours. 1

18. Nurse hours per case in one- to two-OR centers is 6.2 hours. 1

19. Administrative hours at one- to two-OR centers is 3.9 hours. 1

20. Nurse hours at ASCs with three- to four-ORs is 6.1 hours. 1

21. Administrative hours at ASCs with three- to four-ORs is 3.8 hours. 1

Supply chain

22. A single ASC’s average annual supply chain spend is $3.2 million. 3

23. Supply cost as a percent of net revenue is between 17 percent and 25 percent.2

24. A single ASC generates about 1,900 purchase hours annually. 3

25. A typical ASC only utilizes 12 percent of the items in its master. 3

26. An ASC's top 10 vendors comprise about 75 percent of its total spend.3

27. About 96 percent of ASCs think one of the primary functions of a group purchasing organization should be price savings. 4

28. 38 percent of ASCs think one of the primary functions of a GPO should be materials management and procurement services. 4

29. 67 percent would move business to a competing GPO for better pricing opportunities and/or cost savings. 4

Case volumes

30. Typical surgery centers have 18.5 cases per day. 1

31. 32 percent of the cases are performed by the top two physicians at the ASC, 53 percent are performed by the top five physicians, and 71 percent are performed by the top 10 physicians. 1

32. ASCs have an average of 3.1 surgical cases per operating room per day. 1

33. Total cases per center is 4,629 per year. 1

34. 769 cases are performed per operating room annually, with 3.1 cases per day. 1

35. ASC procedure rooms see around 1,083 non-surgical cases per room annually, with 4.3 procedures per day. 1

36. Surgery centers with more than four operating rooms performed 24.5 cases per day, while those with one to two operating rooms performed 10.8 cases per day. 1

37. Surgery centers with three to four operating rooms had the highest annual surgical case rate per operating room, at 740, while those with more than four operating rooms hosted 735 cases annually per operating room. Centers with one or two ORs hosted 697 cases annually per room. 1

38. Non-surgical case volume per year at facilities with one to two operating rooms is 951 cases per procedure room, the most of any number of ORs. 1

39. Surgery centers with three to four ORs reported 844 non-surgical cases per procedure room annually, which dropped to 705 cases in centers with more than four ORs. 1

40. In surgery centers with more than four ORs, only 24 percent of the cases were performed by the top two physicians, while 64 percent were performed by the top 10 physicians. 1

41. From 2007 to 2011, volume of services per Medicare beneficiary grew at a 4.6 annual rate. In 2012, that growth dropped to 1.7 percent. 5

Reimbursement and center growth

42. 76 percent of ASCs say reimbursement is one of the biggest concerns to their business in the next six to 12 months.  4

43. 29 percent think healthcare reform will be one of the biggest challenges to their business over the next six to 12 months. 4

44. 47 percent of ASCs feel aggressively cutting costs, improving managed care, expanding services and reducing staff are their best strategies for success.4

45. 45 percent of ASCs plan to purchase computers over the next 12 months. 4

46. 44 percent of surgery centers plan to standardize their purchases and/or products over the next 12 months. 4.

47. In 2014, HOPD reimbursements for Medicare patients are 81 percent higher than those of ASCs. 5

48. ASC reimbursement as a percentage of HOPD reimbursement ranges between 58 percent and 65 percent 2

49. 79.9 percent of ASCs collect between 0 days to 30 days from the date of service to the check date. 6

50. 13.3 percent of ASCs receive cash collection between 31 and 60 days from the service date to the check date. 6

51. 20 percent of ASC claims are not collected for more than 30 days. 7

52. The top reason for ASC procedures to receive an unexpected denial is "claims or service lacks information which is needed for adjudication." The second most common reason is "duplicate claim or service" followed by "procedure or treatment is deemed experimental or investigational by the payer." 7

53. Commercial insurance companies have a 12 percent unexpected denial rate for the top 10 CPT codes that have unexpected denials at ASCs. 7

54. Medicare's unexpected denial rate is 6 percent for the top 10 CPT codes that have unexpected denials at ASCs. 7

55. Medicaid has a 26 percent denial rate for the top 10 CPT codes that have unexpected denials at ASCs. 7

56. Around 47 percent of ASCs with fewer than 3,000 cases have 0 to 30 A/R days, while 16.5 percent have 31 to 60 A/R days. 1

57. Most ASCs with at least 3,000 cases annually have 0 to 30 A/R days. 1

58. Of all ASCs, about 12.7 percent have more than 120 A/R days. 1

59. For ASCs with three to four ORs, average ENT revenue is $1,919 per case. 1

60. Average GI/endoscopy revenue per case for medium-sized ASCs is $790. 1

61. Orthopedics revenue per case for three- to four-OR ASCs is $2,815. 1

62. Average general surgery revenue per case for medium sized ASCs is $1,894. 1

63. For ASCs with three to four ORs, average ophthalmology revenue is $1,264 per case. 1

64. Average plastic surgery revenue per case for medium-sized ASCs is $1,789. 1

65. Podiatry revenue per case for three- to four-OR ASCs is $2,099. 1

66. For medium sized ASCs, average OB/GYN revenue per case is $2,116. 1

67. Average pain management revenue per case for three- to four-OR ASCs is $819. 1

68. Revenue per case for urology procedures in medium-sized ASCs is $1,623. 1

Clinical procedures

69. Procedure time for cataract surgeries in ASCs is seven minutes to 33 minutes, with an average of 13 minutes.8

70. Pre-procedure time for colonoscopy is seven minutes to 136 minutes with an average of 60 minutes, covering patient check-in to scope insertion.9

71. Colonoscopy procedure time is 11 minutes to 33 minutes, with an average of 17 minutes. 9

72. Preprocedure time for knee arthroscopy is 72 minutes to 115 minutes, with an average of 97 minutes. Organizations with shortest times attribute results to calling patients before the procedure to review instructions and ensure patient histories are complete, and scheduling patients based on each surgeon’s average procedure time. 10

73. Knee arthroscopy procedure time is 16 minutes to 75 minutes, with an average of 28 minutes. 10

74. Discharge time for knee arthroscopy is 55 minutes to 98 minutes, with an average of 79 minutes. Organizations with short discharge times attribute results to providing patient education about what to expect after the procedure and administering a local anesthetic instead of general anesthesia. 10

75. Preprocedure time for low back injections is eight to 111 minutes, with an average of 50 minutes. Organizations with the shortest pre-procedure times attribute results to preparing paperwork and educating patients prior to the day of the procedure, and having staff work as a team to fill in as needed. 11

76. Low back injection procedure time is two minutes to 17 minutes, with an average of seven minutes. 11

77. Discharge time after low back injections is eight minutes to 44 minutes, with an average of 25 minutes. 11

Quality and safety

78. The rate of patient falls is 0.135 per 1,000 admissions. 12

79. The rate of patient burns is 0.017 per 1,000 admissions. 13

80. The rate of hospital transfers/admissions is 1.140 per 1000 admissions. 14

81. The rate of wrong site/side/patient/procedure/implant events is 0.029 per 1,000 admissions. 15

82. The percentage of ASC admissions with antibiotics ordered who received antibiotics on time is 99 percent. 16

83. The percentage of ASC admissions with appropriate surgical site hair removal is 98 percent. 17

Patient demographics

84. 86 percent of ASC patients are Medicaid, while 14 percent are Medicaid beneficiaries. 5

85. About 88 percent of ASC patients are white, 7 percent are black and slightly more than 5 percent are some other race. 5

86. 78 percent of patients are between the ages of 65 and 84, while 15.2 percent are under the age of 65 and 6.8 percent are 85 or older. 5

87. About 58 percent of ASC patients are female, while 42 percent are male. 5

Industry growth benchmarks

88. Between 2007 and 2011, the number of ASCs in the U.S. grew at a 2.5 percent annual rate. In 2012, that rate dropped to 1.2 percent. 5

89. 100 percent of surgery center management companies in the HealthCare Appraisers 2013 ASC Valuation Survey found orthopedics/sports medicine a desirable specialty. 18

90. 94 percent of ASC management companies find orthopedic spine a desirable specialty in 2013.18

91. 94 percent of ASC management companies find ENT desirable in 2013.18

92. 88 percent of ASC management companies find general surgery desirable in 2013. 18

93. 88 percent of ASC management companies find pain management desirable in 2013. 18

94. 82 percent of ASC management companies find gastroenterology a desirable specialty in 2013.19

95. There were 141 new Medicare-certified ambulatory surgery centers in 2013.19

86. There were 85 ASCs Medicare de-certified in 2013, resulting in a net increase of 56 Medicare-certified ASCs over 2012.19

97. Medicare made $3.5 billion in payments to ambulatory surgery centers in 2011.19

98. There were 5,344 Medicare-certified ambulatory surgery centers in 2011, up 1.8 percent over the previous year. 20

99. Between 2001 and 2011, the number of ambulatory surgery center operating rooms doubled in the United States and in 2011, 60 percent of hospitals had an ASC within five minutes of their facility. 21

100. Objective Health predicts that procedure volumes for cases such as shoulder arthroscopy, which Medicare paid ASCs 42 percent lower than hospital outpatient departments in 2012, will continue to increase in ASCs. 21

Endnotes:

1. VMG Multispecialty ASC Intellimarker 2012

2. Avanza Healthcare Strategies Operational Benchmarks

3. Provista procurement expert data 2014

4. 2014 supply chain survey from Provista. Items 27 and 28 are based on a survey of 69 ASCs; item 29 is based on a survey of 45 ASCs; items 42 and 43 are based on surveys of 49 ASCs; item 44 is based on a survey of 51 centers; item 45 is based on a survey of 46 centers and item 46 is based on a survey of 50 centers.

5. March 2014 Medpac report Ambulatory Surgical Center Services

6. RemitData, based on 25 percent of all national outpatient remittances from September 2012.

7. RemitData, based on data collected between Nov. 5, 2012 to Feb. 11, 2013.

8. AAAHC benchmarking study based on clinical studies of cataract extraction surgeries with lens insertions. The study includes 70 organizations with a combined 139,791 cataract surgeries per year. The data was collected between January and June of 2014.

9. AAAHC benchmarking study on clinical findings for colonoscopy from 68 organizations performing 230,126 colonoscopies per year. The data was collected between January and June 2014.

10. AAAHC benchmarking study on clinical findings for knee arthroscopy in the ASC based on data from 14 organizations that perform a combined total of 4,209 knee arthroscopies annually. The study was conducted between January and June 2014.

11. AAAHC benchmarking study on clinical findings for low back pain in ambulatory care settings based on data from 38 organizations that perform a combined total of more than 70,817 low back injections annually. The data was collected between January and June of 2014.

12. ASC Quality Collaboration data representing the experience of 1,609,607 ASC admissions seen at 1,533 facilities between Jan. 1 and March 31, 2014.

13. ASC Quality Collaboration data representing experience of 1,608,080 ASC admissions seen at 1,530 facilities between Jan. 1 and March 31, 2014.

14. ASC Quality Collaboration data representing the experience of 1,598,313 admissions seen at 1,520 facilities between Jan. 1 and March 31, 2014.

15. ASC Quality Collaboration data representing the experience of 1,608,144 ASC admissions seen at 1,528 facilities between Jan. 1 and March 31, 2014.

16. ASC Quality Collaboration data representing the experience of 1,293,150 ASC admissions with antibiotics ordered seen at 1,286 facilities between Jan. 1 and March 31, 2014.

17. ASC Quality Collaboration data representing the experience of 1,082,262 ASC admissions with surgical site hair removal seen at 1,324 facilities between Jan. 1 and March 31, 2014

18. HealthCare Appraisers 2010 ASC Valuation Survey and 2013 ASC Valuation Survey.

19. MedPAC Health Care Spending and the Medicare Program June 2013 Report.

20. March 2013 Report to the Congress: Medicare Payment Policy

21. Objective Health Infographic: The Increased Competition of Ambulatory Surgery Centers (ASCs) to US Hospitals.

 

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months