1. California Ambulatory Surgery Center Association Annual Meeting September 13, 2013

2. Benchmarking is part of our daily lives…

4. You may think you’re good, but…  In reality you don’t know until you are compared to others

5. Why do we benchmark?  Benchmarking is the tool whereby leaders confirm quality, productivity, and profitability  It’s an opportunity for you to protect and improve your business

6. Ways to use benchmarking  Quality Improvement studies  Process Improvement  Payer contracting negotiations  Board meetings  Physician recruiting  Employee recruiting

7. Benchmarking Sources  ASCA  CASA  Management / Affiliated Company  Internal  Outside industry

8. ASCA Benchmarking  Great for quality data because of the large sample size  Financial data is difficult to draw solid conclusions from with dramatic nationwide cost variances  Currently undergoing a significant facelift to make the reports more dynamic and user friendly

9. CASA Benchmarking  CASA’s benchmarking program enables us to have a stronger and more unified voice in our California State advocacy efforts June 2013 article in California Health Care Almanac titled “Ambulatory Surgery Centers: Big Business, Little Data”  Currently 110+ centers reported in 1Q 2013  Dynamic reporting abilities are in development  Currently evaluating questions for relevance

15. Management/Affiliated Company  Incredible resource to drill down further and understand significant differences  Depending on the size of the company, be mindful not to only look here as you could miss opportunities to improve beyond the company benchmarks

16. In 2009…

17. 2009-2013 transfer rate trend lines

18. Internal  “First, know thyself”  Imagine being asked by a surveyor, physician partner, or a potential physician partner a question about your own center that you couldn’t answer yet they expected you to know it  Some of the best benchmarking occurs when you compare against yourself

19. GI Quality Benchmarking

20. Outside Industry Examples  Need to look outside your industry for breakthrough strategies  Patient Satisfaction Surveys Evaluate raffle prizes for completed surveys utilized by retailers and restaurants  Check-in/registration Efficient process with as much of the work done prior to your arrival - equivalent to car rentals  Complaints Resolution through account credits or give aways - similar to hotels and banks

21. Combination Benchmarking  Correlation between late starts and overtime  Quality impacts of an H&P sent prior to surgery vs. the pre-procedure assessment  Correlation between Salary and Benefits and staff turnover  Profitability of specialty by payer

22. Ways to use benchmarking  Quality Improvement studies  Board meetings  Payer contracting negotiations  Physician recruiting  Employee retention

23. Concluding Thoughts  Too often it’s reactive: The number of cancellations are growing Infections are higher than other ASCs  Think of it as proactive: What is a reasonable goal for overall cost per case given our case mix? What would be the average number of medication errors a facility with our volume should have per year?