DATA & INSIGHTS: PAIN

Leveraging data in every aspect of operations is now essential for long-term success.

Pain ASCs showed small gains in OR utilization and patient collections, and improved billing speed by 2 days. Pre-authorization rates jumped to 45%, but cancellations rose and net revenue dipped slightly. Review 10 core KPIs that reveal where pain management centers are improving—and where support is still needed.

This data represents 308,411 unique cases across 325 centers.

OR Block Utilization

OR block utilization increased slightly from 29% to 30%.

Seamless communication between a doctor’s office and the ASC is key to driving case volume. Avoid phone and fax delays—use technology to broadcast OR availability, enable electronic scheduling, and automate block time management to improve efficiency and achieve at least 70% utilization.

Pre-Authorization Rates

Pre-auth approvals surged from 34% to 45%, helping reduce denial risk.

Obtaining prior authorization prevents denials and reimbursement delays. ASCs should verify authorizations secured by the doctor’s office to avoid performing procedures without approval. Leveraging integrated payer technology streamlines the process, reducing administrative burden and ensuring compliance.

Insurance Verification Rate

Verification rate held steady at 84%, maintaining a strong performance baseline.

Verifying insurance eligibility prevents financial issues and last-minute cancellations. ASCs should re-verify coverage twice—upon case acceptance and the morning of surgery—and re-run checks monthly to catch lapses. Automating this process minimizes manual work and ensures seamless patient care.

Case Cancellation Rates

Slight increase—cancellation rate rose from 24.6% to 25.3%.

Maintaining communication with patients, physicians, and vendors keeps cases on track and prevents last-minute cancellations. A centralized system allows the care team to coordinate seamlessly, share updates, and address issues early. Proactive patient communication also reduces the risk of patient-initiated cancellations.

Case Cancellation Reasons

Most cancellations were patient-driven (38%) or due to providers cancelling (21%).

Some case cancellations are unavoidable, but many can be reduced with better processes. Issues like missing labs, scheduling errors, and surgery center inefficiencies are within your control. Analyzing cancellation reasons helps identify areas for improvement, keeping your schedule optimized and reducing lost revenue.

Patient Deposit Collection Rate

Collection rate rose from 68% to 69%, showing slight improvement in upfront payments.

Surgery costs can be overwhelming for patients. Providing accurate estimates 1-2 weeks before their procedure builds trust, reduces cancellations, and improves satisfaction. Using technology, ASCs can generate clear, easy-to-read estimates, send them via text or email, and enable upfront payments.

Days to Bill

Billing speed improved—days to bill decreased from 9 to 7.

Accurate coding and charge entry are essential for reimbursement and compliance. Integrating EHR and billing systems reduces errors and streamlines the process. Using well-trained coders and tracking denials helps prevent mistakes, improving financial health and operational efficiency.

Claim Denial Rate

Denial rate improved, dropping from 11% to 10%.

Efficient claim management is essential for maintaining cash flow and compliance. Using EHR, practice management, and electronic claims systems streamlines submissions and reduces errors. Regularly monitoring claims helps address denials quickly, ensuring timely reimbursement and sustaining operational efficiency.

Net Revenue Per Case

Net revenue dipped slightly—from $3,132 to $3,010 per case.

Beyond patient outcomes, profitability is a top priority for ASCs. Monthly financial reviews help identify trends and address issues quickly. Using analytics tools and standardized reporting ensures data-driven decisions, improving revenue, controlling expenses, and maintaining long-term financial stability.

Case Volume

Case volume grew modestly from 126 to 129, showing steady procedural demand.

Tracking average case volume is essential for forecasting profitability, resource allocation, and expansion planning. Monitoring trends helps ASCs identify growth opportunities, adjust staffing, and optimize OR utilization to maintain efficiency and financial stability in a rapidly evolving healthcare landscape.

State of the Industry Report: Best Practices & Industry Benchmarks for Optimizing ASC Operations

50+ chapters of thoughtfully curated industry research, first-hand experiences, and insightful data.

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Benchmarks & data from 3 million cases

130+ KPIs to track

Best practices for the patient journey

Insights into industry trends

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*Disclaimer: HST Pathways released an updated version of our State of the Industry Report in September 2024, highlighting best practices, key process steps, and KPIs for every step of the patient journey and for nearly every recurring administrative duty. Most importantly, using our own unique dataset from our clients, we were able to extract data points so that anyone in the industry could compare themselves to their peers. We only pulled data from clients who gave us permission, and we omitted any extreme outliers. Data on this page may differ from the full 2024 State of the ASC Industry report. The full report (published September 2024) included data through Q2 2024, while this page (published March 2025) includes data through Q4 2024. Differences are due to the extended timeframe and new data from clients who have since granted permission.

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