Ambulatory surgery centers are still increasingly popular and profitable, but at a slower rate than in the past, according to the Pennsylvania Health Care Cost Containment Council.
In a report released Tuesday, PHC4 said average total margin for Pennsylvania's 271 ASCs was 25.19 percent in 2011, up from 24.99 in 2010. There were about 1 million outpatient visits, an increase of just 0.7 percent from 2010, but procedures increased 2.5 percent and net outpatient total revenue increased 4.8 percent.
Five new ASCs were added across the state in 2011; from 2000 to 2009, an average of 21 ASCs were added each year.
PHC4 said ASCs performed 32.5 percent of total outpatient procedures in the state; the other 67.5 percent were performed at 168 general acute-care hospitals.
For Region 5 — which includes Cumberland, Dauphin, Lancaster, Lebanon and York counties — the total margin averaged 28.43 percent, with a three-year average total margin of 27.52 percent. Medicare represented 21.43 percent of net patient revenue, and Medicaid was 3.74 percent.
The Hospital & Healthsystem Association of Pennsylvania released a statement noting that, compared with the ASCs, GAC hospitals had a much lower total margin. For Region 5, the 2011 average was 9.39 percent, and Medicare and Medicaid represented 33.20 and 7.30 percent of net patient revenue, respectively.
"Pennsylvania's acute-care hospitals play a pivotal role in providing a health care safety net for our most vulnerable citizens," said HAP President and CEO Carolyn F. Scanlan. "With ASCs treating healthier, and usually better insured, patients, the financial and clinical demands on acute care hospitals continue to grow."
However, PHC4 noted that ASC and GAC margins cannot be directly compared. ASCs are generally structured so they're not subject to income taxes; physician owners may receive a distribution of net income and then pay personal income tax. By contrast, GACs usually count physician compensation as an expense before calculating margin and must also pay taxes before margin.