ASCA Survey Shows Salaries and Caseloads Rising

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ASCA Survey Shows Salaries and Caseloads Rising

Data projects hiring increases

BY KAY TUCKER | DECEMBER 2023

ASCs are paying more for nearly every staff position they hire and offering robust benefits packages to help manage increasing caseloads and employee turnover rates that exceeded 20 percent in more than one out of five surgery centers during 2022, data collected in ASCA’s 2023 Salary & Benefits Survey shows. Going forward, centers that participated in the survey reported that they will budget a median 3 percent increase for both hourly and salaried employees.

The median number of patient encounters or cases per year that participants reported rose to 4,000 from 3,483 in 2021. Alongside growing caseloads, 70 percent of the ASCs that participated also projected hiring increases during the year.

Consistent with findings from the 2021 survey, 98 percent of surgery centers reported offering health insurance benefits to their employees and 94 percent reported offering family health insurance plans. This year, the percentage of ASCs offering flexible savings accounts, now 62 percent, surpassed the percentage offering preferred provider organization plans to their employees, now 59 percent, for the first time.

Also consistent with the past, most ASC administrators, business office managers, directors of nursing/head nurses/nurse managers and materials managers are eligible for bonuses. Additionally, 94 percent of ASCs offer retirement benefits and 40 percent, up from 34 percent in the 2021 survey, offer a profit-sharing plan. Ninety-seven percent of centers have employee leave policies, with a median of 22 days as the maximum number of paid time off that full-time employees can earn.

“The results of this survey further demonstrate the need for Medicare to recognize the increasing costs surgery centers are facing—for everything from staffing to supplies and regulatory compliance—and make meaningful adjustments to its payment rates and policies,” says ASCA Chief Executive Officer Bill Prentice. “ASCs are already saving Medicare and its beneficiaries billions of dollars each year when care migrates to our setting. Thanks to the Centers for Medicare & Medicaid Services’ decision to reimburse 37 additional procedures beginning in 2024, including total shoulders and ankles, we will quickly be cutting the program’s expenses even more. With a few other strategic payment changes, these savings could easily go higher.”

Prentice called two findings in the report “concerning”: a 5 percent drop since the 2021 survey in the number of surgery centers that invest in tuition and continuing education for staff and a comparable decline in the number of ASCs that reported providing a financial incentive to administrators who achieve and maintain the CASC credential.

“We routinely hear from ASCs that are having difficulty hiring staff with the ASC management skills they need to assist with day-to-day operations and succession planning,” Prentice says. “Investing in education and training for existing staff can lead to immediate improvements in the quality of care a surgery center provides, improve staff loyalty and help prepare for the future. It’s a win-win-win. As the shortage of healthcare professionals continues, now is the time to make those investments.”

A higher percentage of ASCs, now 30 percent as compared to 20 percent in 2021, reported adopting a mandatory infection preventionist certification requirement. Nearly one in four that do, however, provide no financial incentive to those who achieve and maintain it.

Demographics

More than 450 ASCs participated in this year’s survey, which was open during the entire month of June.

Demographic information the survey collected this year showed the following:

  • physicians own some part or all of 94 percent of the participating ASCs, down from 95 percent in the 2021 survey
  • the median number of full-time employees is 22, up from 20 in 2021
  • the median number of years in business is 17, up from 16 in 2021
  • 31 percent of the ASCs that participated are in the South, 29 percent in the Midwest, 22 percent in the Northeast and 18 percent in the West
  • about one-third of the ASCs are in urban areas and two-thirds in suburban and rural communities, as in 2021

Get the Full Report

ASCA conducts its Salary & Benefits Survey every other year. The survey collects data on 20-plus ASC job positions, employee benefits and ASC demographics. Specific metrics provided in the final report include:

  • salaries and bonuses paid for various positions
  • medical director compensation
  • determinants of annual bonuses for various positions
  • anesthesia salary trends
  • central sterile technician compensation and certification requirements
  • cash-based compensation as a percentage of total expenses
  • benefits cost as a percentage of total compensation
  • percent of health insurance premium paid by the ASC

All ASCs can participate in ASCA’s Salary & Benefits Survey for free and those that complete at least 40 percent of the questions receive personalized results for free. ASCs can use the information in these reports to compare their compensation packages to similar ASCs, negotiate raises, determine salaries and benefits for new positions and ensure they are staying competitive in their marketplace.

The digital survey report allows users to filter their results and make comparisons with other ASCs in the same region, of the same specialty or with similar characteristics, such as number of employees, or total number of patient encounters each year. ASCs that did not participate in this year’s survey can purchase access to the final report on ASCA’s website. ASCA members are eligible for a discounted rate.