Becker's ASC Review

5 ASC MANAGEMENT Surgeon salaries thrive in outpatient settings: Report By Francesca Mathewes S urgeon salaries in private practice and outpatient settings surpass those in hospital settings, according to a report published May 13 in the Journal of the Society of Laparoscopic and Robotic Surgeons. Analyzing data from over 213,000 medical practices from the U.S. Census Bureau and the Bureau of Labor Statistics, the report contradicts the popular narrative of a dying private practice model and addresses differences in compensation across practice settings and subspecialties. It also notes how inconsistencies in data, particularly regarding ownership, complicate the full picture of who actually owns and controls these practices. Here are five takeaways from the report regarding surgeon compensation: 1. Surgeons in private practice earned a mean annual salary of $354,000, 11% more than those in hospitals. 2. Across all industries, surgeons earned an annual mean salary of $338,000 in 2022, the most recently available data. 3. Surgeons earned the highest mean annual salary when employed by outpatient centers at $385,000. Outpatient centers included freestanding surgical, trauma and nonhospital emergency centers, family planning centers, outpatient community centers, HMO clinics, outpatient mental health and substance abuse centers and kidney dialysis centers. 4. Surgeons were paid more by both hospitals and private practice when compared to nonsurgery practicing physicians. 5. Overall, surgeons experienced a salary increase of 48% from 2013 to 2022. n The cost-saving measures ASCs can skip By Claire Wallace A s costs continue to rise for health systems nationwide due to a combination of inflation and ongoing tariff battles, ASCs are trying to find ways to save money. In addition, investment banking firm Goldman Sachs recently forecasts that the U.S. has a 35% chance of entering a recession in the next year, a worrisome development for ASCs. While there are cost-cutting measures that ASCs can implement to save their finances, including improving efficiency, advocating for adjusted payment rates, monitoring cash flow and optimizing their supply chains, sometimes, identifying these measures can be a question of trial and error. Becker's spoke with leaders at four ASCs who implemented cost- cutting measures that ended up being not-so-cost-cutting. Question: What is one cost-cutting measure you implemented that did not work out, or did not work out in the way that you expected? Dawn Bowles-Paine. CEO at Beckley (W.Va.) Surgery Center: Moving away from a single vendor for packs, implants and equipment and moving to multiple vendors to accomplish a cost savings. e cost of the items that could not be fulfilled by the company supplying the packs increased due to the change and has all but washed out the cost savings. e learning curve with new equipment and products has negatively impacted our efficiency, thus costing us clinical time per case as well as staff and physician satisfaction. Adam Bruggeman, MD. Spine Surgeon at Texas Spine Care (San Antonio): We have tried many different ways to handle revenue cycle management, both from a growth perspective as well as a cost perspective. While we utilize third-party billers, it has always been beneficial for us to maintain an internal billing presence as an audit to the third-party billing entities. We have found this hybrid method, while more expensive, produces the best return on investment. Brooke Day. Administrator at Hastings (Neb.) Surgical Center: Years ago, we started using a credit card with vendors who didn't charge processing fees and reinvested the cash-back rewards into staff appreciation efforts. We were able to fund morale boosters like pedal bike events, meals and other meaningful perks without touching our operating budget. It genuinely made a noticeable impact on our team. However, more vendors are either tacking on credit card fees or requiring ACH payments, which is limiting our ability to use the card as freely as we once did. While we're still committed to maximizing it as long as we can, this strategy may not be as sustainable in the future. It was a smart idea that paid off for years — but like many cost-cutting measures, it's now bumping into industry changes we can't control. Andrew Lovewell. CEO at Columbia (Mo.) Orthopaedic Group: One cost-cutting measure that I can think of is the standardization of implants. We tried this years ago and found that the clinical efficiencies outweighed the incremental cost savings. In the short term, we saved money, but in the long run, physician efficiency in the OR was what was important. From my perspective, you cannot pinch pennies to prosperity. If you save $7 on a screw but add 15-30 minutes to a case that was a net negative decision. One of, if not the most valuable resource we have in our ASCs is the time in the OR. We all have to work as diligently as we can to optimize all of the time in the OR. For example, we have added costs to cases in the past to transition them from the OR to a lower acuity procedure room, so we can backfill that OR with total joints or spine. is may seem counterintuitive at first, but then, when you look at the margin from that day compared to others, it shows that it is a winning strategy. n

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