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The State of Ambulatory Surgery Center Growth in 2022

August 25, 2022 By SIS Corporate

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An in-depth look at the current status of the ambulatory surgery center (ASC) industry in 2022, including case volume and financial metrics.

state of ASC Industry 2022 whole imageAccess to safe and efficient surgical care is fundamental, and ambulatory surgery centers (ASCs) have made surgical procedures available to a vast majority of our nation's communities for over 50 years. Beyond their geographical access, ASCs have also improved the financial access to procedures for patients who may otherwise not be able to afford extended stays at hospitals in their area.

Surgery centers are continually evolving, adding more procedures to the outpatient setting and becoming more efficient. As healthcare costs continue to rise, the ASC industry is a reminder that patients have options for receiving high-quality, lower-cost care.

As National ASC Month wraps up, let's celebrate ambulatory surgery centers' growth and impact as a pillar of the healthcare industry!

State of the Industry

  • Number of ASCs in the country – 6000+
  • Annual ASC Growth Rate – 2.5%
  • Percentage of For-Profit ASCs – 95%
  • Percentage of Urban ASCs 93%
  • National Average # of Specialties Served Per ASC – 2.84
  • Fastest Growing ASC Specialty – Cardiology
  • Specialties Receiving Highest Estimated Medicare Payment Increase in 2022 – Cardiology, Musculoskeletal, Urology

Sources: ASC Data, Ambulatory Surgery Center Association, Avanza Client Database, Becker's ASC Review, Centers for Medicare & Medicaid Services, Definitive Healthcare, FAIR Health, HealthCare Appraisers, McKinsey & Company, MedPAC, Surgical Notes, Advisory Board, United Health Group, VMG Health. Based on data available as of January 2022

Ownership Structure

  • Physician Only – 60%
  • Hospital-Physician – 17%
  • Corporate-Physician – 13%
  • Corporate only – 5%
  • Hospital only – 3%
  • Other – 2%

Sources: ASC Data, Ambulatory Surgery Center Association, Avanza Client Database, Becker's ASC Review, Centers for Medicare & Medicaid Services, Definitive Healthcare, FAIR Health, HealthCare Appraisers, McKinsey & Company, MedPAC, Surgical Notes, Advisory Board, United Health Group, VMG Health. Based on data available as of January 2022

Facility Size

  • Small (1-2 ORs) – 54%
  • Medium (3-4 ORs) – 30%
  • Large (5-6 ORs) – 10%
  • Mega (7+ ORs) – 6%

Sources: ASC Data, Ambulatory Surgery Center Association, Avanza Client Database, Becker's ASC Review, Centers for Medicare & Medicaid Services, Definitive Healthcare, FAIR Health, HealthCare Appraisers, McKinsey & Company, MedPAC, Surgical Notes, Advisory Board, United Health Group, VMG Health. Based on data available as of January 2022

Financial Metrics (Median)

  • Salaries, Wages and Benefits as % of Net Revenue – 23%
  • Benefit Cost as % of Total Compensation – 15.0%
  • Salaries, Wages as % of Net Revenue – 29.3%
  • Supply Cost a % of Net Revenue – 27.8%
  • Number of Days Cash on Hand – 56
  • Days in A/R – 35-45 days
  • A/R over 90 days – <15%
  • Clean Claims – 98%
  • Denial Rate – <5%

Sources: ASC Data, Ambulatory Surgery Center Association, Avanza Client Database, Becker's ASC Review, Centers for Medicare & Medicaid Services, Definitive Healthcare, FAIR Health, HealthCare Appraisers, McKinsey & Company, MedPAC, Surgical Notes, Advisory Board, United Health Group, VMG Health. Based on data available as of January 2022

Case Volume Metrics (Median)

  • Annual surgical cases per operating room – 1,104
  • Annual procedures per procedure room – 1,357
  • Annual Orthopedic cases per room – 800
  • Annual Ophthalmology cases per room – 1,400
  • Annual Gastroenterology cases per room – 1,500

Sources: ASC Data, Ambulatory Surgery Center Association, Avanza Client Database, Becker's ASC Review, Centers for Medicare & Medicaid Services, Definitive Healthcare, FAIR Health, HealthCare Appraisers, McKinsey & Company, MedPAC, Surgical Notes, Advisory Board, United Health Group, VMG Health. Based on data available as of January 2022

Medicare-Certified ASCs by Specialty Type
Percentages don't add up to 100 because centers may have more than one specialty

  • Orthopedic – 37% (2231)
  • Pain – 35% (2151)
  • Ophthalmology – 35% (2102)
  • Endoscopy – 32% (1956)
  • Plastic – 29% (1759)
  • Podiatry – 28% (1714)
  • Otolaryngology – 23% (1424)
  • Obstetrics/Gynecology – 19% (1169)
  • Dental – 8% (497)

*Based on data provided by the Centers for Medicare & Medicaid (CMS), March 2022

Single-Specialty, Medicare-Certified ASCs by Specialty Type

  • Endoscopy – 27% (835)
  • Ophthalmology – 25% (753)
  • Other – 18% (554)
  • Pain – 12% (363)
  • Plastic – 6% (187)
  • Orthopedic – 5% (158)
  • Podiatry – 3% (106)
  • Dental – 2% (49)
  • Obstetrics/Gynecology – 1% (37)
  • Otolaryngology – 1% (30)

*Based on data provided by the Centers for Medicare & Medicaid (CMS), March 2022

Multi-Specialty, Medicare-Certified ASCs by Specialty Type
Percentages don't add up to 100 because centers may have more than one specialty

  • Orthopedic – 69% (2073)
  • Pain – 60% (1788)
  • Podiatry – 54% (1608)
  • Plastic – 52% (1572)
  • Otolaryngology – 47% (1394)
  • Ophthalmology – 45% (1349)
  • Obstetrics/Gynecology – 38% (1132)
  • Endoscopy – 37% (1121)
  • Dental – 15% (448)

*Based on data provided by the Centers for Medicare & Medicaid (CMS), March 2022

Revenue Per Case by Specialty (Median)

  • Sports Orthopedics - $3,764
  • Gynecology - $2,933
  • Podiatry - $2,688
  • Otolaryngology - $2,543
  • Urology - $2,483
  • General Surgery - $2,458
  • Plastic Surgery - $2,010
  • Ophthalmology - $1,442
  • Pain Management - $968
  • Gastroenterology - $800

Sources: ASC Data, Ambulatory Surgery Center Association, Avanza Client Database, Becker's ASC Review, Centers for Medicare & Medicaid Services, Definitive Healthcare, FAIR Health, HealthCare Appraisers, McKinsey & Company, MedPAC, Surgical Notes, Advisory Board, United Health Group, VMG Health. Based on data available as of January 2022

 

The Impact of Ambulatory Surgery Centers

As we wrap up this year's National ASC Month, remember one of the best efforts you can take to raise awareness of the ASC industry is to contact your local officials. We've provided a handy template to make it easier for you to write your local congress members. You can find out who and where to send letters for your location here, and you can also find your local senators here. We at SIS are honored to serve the ASC community and are thankful for the care provided by outpatient surgery centers.

View the template for U.S. Representative here

View the template for U.S. Senator here

Topics: Ambulatory Surgery Centers

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