In today’s tech-savvy world, the process of tracking, measuring and comparing clinical data is easier than ever before. As the healthcare industry becomes increasingly competitive, with health systems vying for market share in communities across the country, it is important to remember that measuring the health of your ASC can be as easy as clicking a few buttons. According to the National Quality Forum’s website, “The science of measuring healthcare performance has made enormous progress over the last decade, and it continues to evolve…Measures represent a critical component in the national endeavor to assure all patients of appropriate and high-quality care.” The NQF continues to explain how quality measures drive improvement, inform consumers and influence payment: “Teams of healthcare providers who review their performance measures are able to make adjustments in care, share successes, and probe for causes when progress comes up short — all on the road to improved patient outcomes.” The following are four key operational metrics to regularly monitor to design future goals and develop strategic business plans for the growth of your ASC:
Physician case volume
The first metric to look at is case volume by physician. Fortunately, EMR systems have simplified our ability to measure a physician’s past productivity and predict the physician’s future capabilities. ASC administrators are no longer required to blindly guess the case load a physician can handle at any given point; instead, they can use hard data from previous months and years to predict, with high accuracy, a physician’s projected volume in the coming year. In addition, this data provides a window of opportunity to meet with physicians and discuss their productivity. By explaining to physicians what an additional number of cases per month could do for the center’s bottom line and, therefore, the physician’s income, ASC leaders can create a collaborative environment in which all leaders are working together to increase the center’s productivity, growth and success rate.
Revenue per case
The net revenue per case is a critical number to consistently monitor within an ASC. This number can be sorted and understood by specialty or by payer, and both are equally important to track over time. This will enable ASC leaders to understand the causes behind any ups or downs of net revenue, and position the ASC for more “ups.” For example, if an ASC specializing in orthopedics hires a gastroenterologist, the case volume may increase but the net revenue may decline, since those cases are typically reimbursed less than orthopedic procedures. In addition, it is critical to understand an ASC’s payer mix and how best to navigate it. If a center’s case volumes are usually 30 percent Medicare, and a surgeon is hired and performs a high percentage of Medicare cases, the net revenue will also decrease.
Labor hours per case
According to Tom Jacobs, CEO of MedHQ, labor costs average 30 percent of an ASC’s expense line. Therefore, knowing the number of clinical staff necessary to support an ASC’s level of volume is critical to ensure smoothly run operations and a staff that is neither over- nor under-utilized. For example, if there are five full-time nurses at a center, but one physician retires and will not be replaced, is it practical to have five nurses continue working 40 hours per week? Could their hours be slightly reduced so the center is not over-staffed? Labor hours per case and labor costs per case are critical when measuring current case volumes and predicting future case volumes, but also when determining the labor needed to support those predicted volumes. This is especially important when a center introduces a new specialty or service offering. What is the projected revenue and supply/implant cost from each case, and is it financially lucrative when incremental labor hours and labor costs are taken into consideration? This not only affects clinical staff, but billing staff as well. Are an ASC’s billing procedures in-house or outsourced, and is this current setup the best option financially for the ASC? Adjusting labor if the case volume experiences significant changes is a critical action to support a healthy and successful ASC.
Supply costs
It is critical to maintain an ongoing understanding of the ASC’s supply costs throughout the year. Capital expenditures, upcoming equipment purchases and even anticipated increases in rent are all numbers to consider when examining the health of an ASC. Is the center introducing a new specialty or new technology that may impact cash flow? Does a certain piece of equipment need to be replaced, or is the facility hiring a new physician? These are all questions to keep on administrators’ radar as the ASC continues to operate and plans for the future. In a competitive market, many aspects of daily operations can shift and evolve at an increasingly rapid pace. By understanding what the ASC’s current supply costs are, as well as upcoming purchases or expenditures, ASC leaders can confidently monitor their facility’s growth and accurately anticipate any bumps in the road to success. For more information about key operational metrics to track, contact mlau@regentsh.com
