Here are 112 operations, finances and quality benchmarks in ASCs gathered from several sources across the industry.
Operational
The following ASC salary and benefits statistics are from the HealthCare Appraisers "ASC Valuation Survey 2018: How Do ASC Companies Assess Value?" including responses from 15 ASC companies representing more than 700 surgery centers throughout the U.S. The centers include only those that are in-network.
Salary and benefits
1. 10 percent to 19.9 percent of revenue: 7 percent of respondents
2. 20 percent to 29.9 percent of revenue: 87 percent
3. 30 percent to 39 percent of revenue: 7 percent
Occupancy
4. 0 percent to 9.9 percent of revenue: 33 percent of respondents
5. 10 percent to 19.9 percent of revenue: 60 percent
6. 20 percent to 20.9 percent of revenue: 7 percent
Drug, medical supplies and implantables
7. 10 percent to 19.9 percent of revenue: 40 percent
8. 20 percent to 20.9 percent of revenue: 60 percent
Management fees
9. Management fees vary based on revenue levels: 40 percent
10. ASC management fee arrangements where a portion of the fee is at risk: 13 percent
11. Minimum fees:
• Less than $100,000: 13 percent
• $100,000 to $199,999: 50 percent
• $200,000 to $299,999: 25 percent
• More than $300,000: 13 percent
12. Threshold when ASC management fees decrease:
• Average annual income less than $500,000: 33 percent
• $500 million to $749 million: 33 percent
• $750 million to $999 million: 17 percent
• $10 billion to $12.49 billion: 17 percent
13. Billing fees as a percentage of net revenue:
• 2 percent to 2.9 percent: 10 percent
• 3 percent to 3.9 percent: 10 percent
• 4 percent to 4.9 percent: 38 percent
• 5 percent to 5.9 percent: 19 percent
• 6 percent to 6.9 percent: 14 percent
• More than 7 percent: 10 percent
Staffing
The following statistics are based on VMG Health’s Intellimarker Ambulatory Surgical Centers Financial & Operational Benchmarking Study 2018 report. The study includes an analysis of more than 275 licensed freestanding ASC covering more than 1.3 million cases.
14. Employee salaries and wages:
• As a percentage of net revenue: 22 percent
• Per square foot: $136
• Per operating room: $516,000
• Per case: $442
15. Employee benefits:
• As a percentage of net revenue: 5.2 percent
• Per square foot: $32
• Per operating room: $121,000
• Per case: $104
16. Staff hours per case:
• Nurse: 6.6
• Tech: 3.0
• Administrative: 4.3
• Total: 13.6
17. Hourly wages:
• Nurse: $36.68 per hour
• Tech: $23.83 per hour
• Administrative: $27.44 per hour
Working capital
The following statistics are based on VMG Health’s Intellimarker Ambulatory Surgical Centers Financial & Operational Benchmarking Study 2018 report. The study includes an analysis of more than 275 licensed freestanding ASC covering more than 1.3 million cases.
Atlantic
18. Cash and equivalents: $564,000
19. Percent of total operating expenses: 9.4 percent
20. Days cash on hand: 34.5
21. Net accounts receivable: $769,000
22. Percent of net operating revenue: 8.6 percent
23. Net working capital: $1,137,000
Midwest
24. Cash and equivalents: $695,000
25. Percent of total operating expenses:9.1 percent
26.Days cash on hand: 33.1
27. Net accounts receivable: $1,084,000
28. Percent of net operating revenue: 11.0 percent
29. Net working capital: $1,355,000
Mountain
30. Cash and equivalents: $463,000
31. Percent of total operating expenses: 6.0 percent
32. Days cash on hand: 22.1
33. Net accounts receivable: $761,000
34. Percent of net operating revenue: 8.5 percent
35. Net working capital: $1,141,000
Northeast
36. Cash and equivalents: $672,000
37. Percent of total operating expenses: 10.4 percent
38. Days cash on hand: 38.1
39. Net accounts receivable: $1,118,000
40. Percent of net operating revenue: 48.6 percent
41. Net working capital: $1,368.000
Pacific
42. Cash and equivalents: $758,000
43. Percent of total operating expenses: 9.5 percent
44. Days cash on hand: 34.7
45. Net accounts receivable: $965,000
46. Percent of net operating revenue: 10.2 percent
47. Net working capital: $1,376,000
South
48. Cash and equivalents: $889,000
49. Percent of total operating expenses: 11.7 percent
50. Days cash on hand: 42.8
51. Net accounts receivable: $836,000
52. Percent of net operating revenue: 7.5 percent
53. Net working capital $1,267,000
Payer mix
The following statistics are based on VMG Health’s Intellimarker Ambulatory Surgical Centers Financial & Operational Benchmarking Study 2018 report. The study comprised an analysis of more than 275 licensed freestanding ASC covering more than 1.3 million cases.
54. Medicare:
• Mean: 29 percent
• 25th percentile: 17 percent
• Median: 27 percent
• 75th percentile: 39 percent
• 90th percentile: 49 percent
55. Medicaid:
• Mean: 10 percent
• 25th percentile: 4 percent
• Median: 6 percent
• 75th percentile: 13 percent
• 90th percentile: 25 percent
56. Commercial:
• Mean: 54 percent
• 25th percentile: 41 percent
• Median: 55 percent
• 75th percentile: 65 percent
• 90th percentile: 72 percent
57. Workers Comp:
• Mean: 7 percent
• 25th percentile: 2 percent
• Median: 4 percent
• 75th percentile: 10 percent
• 90th percentile: 14 percent
58. Self-Pay:
• Mean: 6 percent
• 25th percentile: 2 percent
• Median: 3 percent
• 75th percentile: 6 percent
• 90th percentile: 12 percent
59. Other Pay:
• Mean: 9 percent
• 25th percentile: 2 percent
• Median: 6 percent
• 75th percentile: 13 percent
• 90th percentile: 21 percent
Quality
The following data is based on the ASC Quality Collaboration Quality Report from the second quarter of 2018. There were 1,586 ASCs participating. The data was collected April 1, 2018 through June 30, 2018. There were 986 multispecialty ASCs and 600 single specialty ASCs representing every state except Vermont.
60. Patient fall rate per 1,000 ASC admissions: 0.096
61. Patient burn rate per 1,000 ASC admissions: 0.015
62. Hospital transfers/admissions per 1,000 ASC admissions: 0.944
63. Rate of wrong site, side, patient, procedure, implant per 1,000 ASC admissions: 0.025
64. Rate of prophylactic IV antibiotic timing: 98 percent
65. Percentage of ASC admissions with appropriate surgical site hair removal: 98 percent
66. Percentage of eligible ASC patients with normothermia: 97 percent
67. Percentage of ASC cataract patients with unplanned anterior vitrectomy: 0.44 percent
68. Rate of toxic anterior segment syndrome per 1,000 admissions: 0.12
69. Rate of emergency department visits within one day of discharge per 1,000 admissions: 0.86
70. Rate of unplanned hospital admissions within one day of ASC discharge per 1,000 admissions: 0.43
YAG laser posterior capsulotomy
Benchmarking study from AAAHC based on clinical studies of YAG laser posterior capsulotomy surgeries between January and June 2018. The study includes 25 organizations with a combined 15,788 YAG laser posterior capsulotomies surgeries per year.
71. Eighty-eight percent of patients wait less than one month after scheduling YAG laser surgery before undergoing the procedure.
72. One-hundred percent of patients resume daily living within a week of undergoing YAG laser surgery.
73. Eighty-nine percent of patients reported improved vision after YAG laser surgery in an ASC.
74. Ninety-nine percent of patients say they're comfortable while undergoing YAG laser surgery in the ASC.
75. Ninety-eight percent are comfortable after discharge.
76. Ninety-nine percent of patients report they would recommend YAG laser surgery after undergoing the procedure in an ASC.
77. Median preprocedure time is 47 minutes for YAG laser surgeries, with a range of 18 to 75 minutes.
78. Median procedure time for YAG laser surgeries in ASCs is two minutes with a range of one to 11 minutes.
79. Median discharge time for cataract surgeries is six minutes.
Colonoscopy
The data in this section is based on a benchmarking study from AAAHC on clinical findings for colonoscopy from 47 organizations performing 199,522 annual colonoscopies between January and June 2018.
80. Sixty-nine percent of colonoscopy patients report little or no discomfort during bowel preparation.
81. Seventy-six percent of colonoscopy patients wait less than a month between scheduling their colonoscopy and having the procedure.
82. Ninety-six percent of colonoscopy patients report scheduling their procedures as soon as they wanted.
83. Ninety-eight percent of colonoscopy patients experienced little or no discomfort during the procedure.
84. Ninety-nine percent of colonoscopy patients report being comfortable after discharge.
85. Ninety-eight percent would recommend colonoscopy at the center to others.
86. Colonoscopy procedure time is eight to 23 minutes.
87. Preprocedure time for colonoscopy is six to 124 minutes, covering patient check-in to scope insertion.
88. Colonoscopy discharge time is 16 to 52 minutes for ASCs.
Knee arthroscopy
The following is based on a benchmarking study from AAAHC on clinical findings for knee arthroscopy in the ASC based on data from 20 organizations that perform a combined total of 5,270 knee arthroscopies annually. The study was conducted between January and June 2018.
89. Median preprocedure time for knee arthroscopy is 108 minutes, and organizations with shortest times attribute results to educating patients on what to expect during the procedure at the preop visit and having consistent, reliable staff.
90. Median knee arthroscopy procedure time is 24 minutes in the ASC.
91. Median discharge time for knee arthroscopy is 67 minutes in the ASC, and organizations with short discharge times attribute results to using the appropriate amount and type of anesthesia specific to each patient and educating patients on what to expect in terms of pain management post-procedure.
92. Seventy-six percent of knee arthroscopy patients wait less than a month for their procedure after scheduling.
93. Eighty-eight percent of knee arthroscopy patients are able to schedule the procedure as soon as they wanted in the ASC.
94. Ninety-nine percent of knee arthroscopy patients say they are comfortable post-discharge in the ASC.
95. Over 99 percent of knee arthroscopy patients report little or no discomfort during the procedure.
96. Ninety-nine percent would recommend knee arthroscopy at the center to others
Low back injections
The following is based on a benchmarking study from AAAHC on clinical findings for low back pain in ambulatory care settings based on data from 28 organizations that perform a combined total of more than 47,598 low back injections annually. The data was collected between January and June 2018.
97. Median preprocedure time for low back injections is 56 minutes, and organizations with the shortest pre-procedure times attribute results to preparing the paperwork and educating patients prior to the day of the procedure.
98. Median procedure time is five minutes for low back injections in the surgery center.
Median discharge time after low back injections in the ASC is 21 minutes, with a range of six to 49 minutes.
99. Eighty-seven percent of patients wait less than a month from scheduling their low back injection to undergoing the procedure in the ASC.
100. Ninety-four percent of patients say they are able to schedule their low back injections in an ASC within a "reasonable" period to time.
101. Eighty-four percent of patients report returning to daily activities after undergoing low back injections in ASCs.
102. Eighty-three percent of patients say they experienced less pain after the low back injections.
103. Fifty-four percent reduced pain medications after the procedure.
Case volume & revenue
The following statistics are based on VMG Health’s Intellimarker Ambulatory Surgical Centers Financial & Operational Benchmarking Study 2018 report. The study includes an analysis of more than 275 licensed freestanding ASCs covering more than 1.3 million cases.
104. Case volume mix as a percentage of total cases:
- Gastroenterology: 34 percent
- Ophthalmology: 26 percent
- Orthopedics: 21 percent
- Pain management: 21 percent
- Otolaryngology: 12 percent
- General surgery: 9 percent
- Oral surgery: 9 percent
- Urology: 8 percent
- Obstetrics and gynecology: 6 percent
- Plastic surgery: 5 percent
- Podiatry: 6 percent
105. Net revenue per case:
- Orthopedics: $3,458
- Otolaryngology: $2,543
- Podiatry: $2,688
- Urology: $2,483
- Obstetrics and gynecology: $2,933
- General surgery: $2,235
- Plastic surgery: $2,010
- Ophthalmology: $1,442
- Oral surgery: $950
- Pain management: $1,245
- Gastroenterology: $1,027
ASC leader pay and demographics
The following statistics are based on OR Manager’s 2018 Salary/Career survey, which fielded responses from ASC and hospital administrators across the U.S. on salary, job satisfaction and more.
106. Forty-three percent of hospital leaders said they earned $120,000 or more, compared to 37 percent of ASC leaders.
107. In 2017, 40 percent of hospital leaders said they earned $120,000 or more, compared to 29 percent for ASC leaders.
108. Only 16 percent of ASC leaders said they earned less than $80,000.
109. The average age of respondents was 51.7 years old.
110. Thirty-four percent of respondents had a master's degree.
111. Eighty-nine percent were female.
112. Over 70 percent were RNs.