Staffing can make or break an ambulatory surgery center (ASC).
According to VMG Health’s 2017 Intellimarker ASC study, multi-specialty
outpatient surgery facilities spend an average of 22 percent of their
net operating revenue on employee salaries and wages. On an average ASC’s
income statement, staffing costs make up the second biggest line item
expense after drugs and medical supplies (24 percent). That’s higher
than administrative costs (17 percent), occupancy costs (7 percent), and
taxes and benefits (5 percent).
Here are important factors that will assist you in determining if staffing
issues are affecting your center:
Appropriate work experience
Typically, ASCs can only hire local candidates for long-term positions.
If hiring managers become anxious about filling a position, they may overlook
critical skills gaps or hire an individual with only the baseline qualifications.
This is a mistake. For example, hiring an unqualified administrator who
doesn’t possess the right analytics experience may make it difficult
to identify a center’s financial performance problems, address these
underlying issues and achieve real costs savings.
All employees should have a working understanding of the ins and outs of
their facility, its processes and how they can be improved. Administrators,
in particular, should be fluent in all business office functions, such
as benefits verification, patient financial responsibility, customer service
and cost analysis. Inefficiency and cost overruns can be experienced when
employees lack a full understanding of the operations, especially when
the ASC is overstaffed.
In many cases, the difference between a surviving and thriving ASC comes
down to staffing efficiency. Overstaffing a surgery center will negatively
affect profitability in a hurry — especially as the cost of payroll-related
benefits continues to rise. Instead of hiring more full-time employees,
consider using flex staffing to meet hourly caseload needs. It’s
also important to hire both full- and part-time employees when running
a successful center.
Turnover and understaffing
Losing an employee is very expensive. According to the Society for Human
“The average cost-per-hire is $4,129, while the average time it takes
to fill a given position is 42 days. In terms of employee retention, the
average employee tenure is eight years, the annual turnover rate is 19
percent and the involuntary turnover rate is 8 percent.”
Turnover also can extend the revenue cycle, as claims may be submitted
more slowly. When remaining staff are overwhelmed, claim rejection rates
could rise. What’s more, having too few employees also can create
inefficiencies, as AR days may increase, collecting from patients becomes
more difficult, and ultimately, cash flow is slowed down.
Continuing employee education is essential but often overlooked in outpatient
surgery. Business office staff must be up to date with the latest insurance
verification requirements, how to calculate out-of-pocket costs, regulatory
changes, facility contracts and customer service issues.
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