Oct 31, 2013 4 min read

Ambulatory surgery centers – those that enable patients to have surgical procedures and return home in the same day – continued to increase their presence in the region and across the state last year, according to a study released Thursday.

The Pennsylvania Health Care Cost Containment Council reported that the state added 10 ASCs last year, bringing the total to 281 units. The units reported 1.1 million outpatient visits and $1.1 billion in net outpatient revenue during fiscal year 2012, with the number of procedures at ASCs increasing 0.7 percent.

Commercial health insurance plans covered 51.4 percent of outpatient procedures at ASCs in 2012.

At the same time, the average operating margin among ASCs increased from 24.94 percent to 25.83 percent, with total margin rising from 25.12 percent to 27.01 percent.

“The financial margins for Pennsylvania’s ambulatory surgery centers continued to increase in FY12,” said Joe Martin, executive director of PHC4. “The number of ASCs also continued to grow, although not as rapidly as during the last decade.

The report divides the state into nine regions, and tracks data from fiscal year 2003, when Pennsylvania had 127 ASCs, through last year.

Between fiscal 2011 and 2012, 15 ASCs opened and five closed. Of the facilities that opened, five were in Region 1, which includes Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Washington and Westmoreland counties.

Region 1, which has seen the number of ASCs grow from 23 in 2003 to 47 last year, saw average operating margins of 17.11 percent and total margin of 17.22 percent from an average visit of 3,925 among the 47 units.

Operating margin is the ratio of operating income to total operating revenue. Total margin is the ratio of total income to total revenue.

The study notes that there is a wide variation in the level of resources provided per visit among ASCs and hospital outpatient departments. For example, a patient may receive care as a series of visits comprised of relatively short treatments, such as for psychotherapy in a hospital outpatient setting, while a patient at an ASC may be subject to an entire surgical procedure during a single visit.

Region 1 includes four ambulatory surgery centers in Washington County: Peters Township Surgery Center on Gallery Drive, which opened last year; Southwestern PA Eye Surgery Center in Washington; Spartan Health Surgery Center in Monongahela; and Tri-State Surgery Center on Leonard Avenue in Washington.

With the exception of the new Peters Township facility, visits to the other three ASCs in the county were near or above the state and regional averages of 3,989 and 3,925 respectively.

According to the PHC4 data, the Peters Township facility had $631,000 in revenue in its first fiscal year of operations, with total operating expenses of $2.1 million. It had 657 visits.

Southwestern PA Eye Surgical Center served 3,796 patients in FY12, with net patient revenue of $3.5 million on total operating expenses of $3.04 million.

Southwestern had operating and total margin of 13.49 percent in FY12. It received 83.73 percent of net patient revenue from Medicare.

Spartan Health Surgery Center in Monongahela treated 4,034 patients for net patient revenue of $3.1 million, up 8.8 percent over the past three years. Its total operating expenses last year were $2.3 million, and had risen 2.25 percent over the past three years. Its FY12, operating margin was 23.77 percent, with total margin at 23.97 percent. The facility received 40.17 percent of net patient revenue from Medicare.

Tri-State Surgical Center logged 6,507 visits last year, the highest of the four local ASCs, for net revenue of $6.39 million, with operating expenses of $5.1 million. It recorded a half percentage point decline in operating expenses over the past three years. Tri-State, which recently broke ground for a new facility in North Strabane Township, had a 19.28 percent operating margin last year, with a total margin of 19.49 percent.

PHC4 is an independent state agency that collects, analyzes and reports information that can be used to improve the quality and restrain the cost of health care in Pennsylvania.