An Industry Survey of Cath Lab Performance in North America

In January of 2012, Springboard HealthCare conducted an inaugural industry survey to benchmark cath lab performance in areas of revenue, expenses, facility outlook and company culture. The purpose of the survey was to establish an index to detail industry trends, sentiment, and growth prospects by cardiac cath lab leaders. Cath lab leaders and staff members from across the nation were asked to participate in the twenty-six question survey. Three hundred fifty-nine respondents from the industry contributed to the survey results with over 90% representing hospital-based catheterization labs. The remaining 10% of the respondents equally represented private practice and VA/government facilities.

Survey results show that the responses collected represent an evenly distributed sample of cath labs with revenues ranging from less than $5 million to over $200 million. Thereby the results discussed herein are not slighted toward any particular size of cath lab, although responses were not segmented by revenue groups. Seventy-eight percent of the respondents perceive the revenue trend for their facility to stay the same or improve in 2012.

Revenue Trends

Responses to the surveys showed that 40% of the respondents experienced increased volumes during the last three months, another 43.5% reported steady volumes, while only 16.5% reported decreased volumes (Figure 1). Of those experiencing increased volumes:

• Half report volume increases of less than 10%.
• Nearly one-third report volume increases of 10%-20%. 
• One-eighth claim volume increases of 20-30%.
• Four percent boast increases of 60%.

Those that experienced a loss in volume declined to quantify their decrease.

Volume increases were attributable to a number of factors, identified in Figure 2. Among them, physician relationships were a key contributor to volume increases claimed by the respondents. When considering written responses in the “Other Factors” category, nearly half of all increases were attributed to new relationships with physicians, re-engaged or redefined relationships with physicians (through purchase of physicians’ groups) or improving physician relations.

Physician relationships are having a large impact on volume increase because the reimbursements from Centers for Medicare & Medicaid Services (CMS) to cardiologists are down and the overhead is up. This has led to Accountable Care Organizations (ACO) involvement in cath lab operations.

Other Factors Contributing to Volume Increases

Respondents clarified “other factors” as including:

• Expanding current services
• Creating new or strengthening physician relationships 
• Seasonal Increases (for winter destination locations)

Volumes were ranked the #1 challenge during 2011, and are forecasted to remain the #1 challenge for cath labs in 2012 by survey respondents.  

Revenue Sources

Among the revenue sources for cath labs, diagnostic health catheterization claimed to be the leading core service (as a percentage of overall revenue), representing 37.7% of all revenue generation and accounting for nearly double the revenue share of the next closest revenue contributor (PCI). When evaluating your short-term strategic plan for capturing market share, Figure 3 shows what the respondents claim about the revenue contributors in their lab.

Survey respondents indicated that 2012 investments in capital equipment for their lab would be made in the areas as described in Figure 4.

Cath Lab Culture: The Working Environment for Cath Lab Staff

Just over 72% of respondents indicated that they were satisfied with their current position. Of those that indicated dissatisfaction, the respondents indicated that they are pursuing one or more of the following courses:

• 45.4% are pursuing more education
• 15.1% are considering a new career in another field
• 36.4% are considering opportunities in other cath labs 
• 39.4% are pursuing another opportunity 
• 9% are looking to retire 
• 86.9% of the respondents feel good about the morale in the workplace, listing it as “good/improving or excellent,” and attribute positive morale to direct management support. Having a staff voice to give input or mutual respect and positive relationships with the physicians was also a contributing factor to good morale. Although our survey indicates strong support from cath lab managers and directors, it also found the perception of support from management fades at the VP and CEO levels. 

Those that felt the morale was less than good attributed that to being understaffed, having poor communication or over-utilization of the call team. Reduced hours/overtime was also noted as detracting from good morale. When working with physicians in the cath lab, 70% describe the working relationship to be exceptional or working well. A large majority of the dissenters feel that there is room for improvement, but stop short of describing the relationships as disrespectful.

2012 Survey Summary

In an otherwise rocky economy, the cath lab industry is perceived as stable by industry professionals. Morale remains high and although volume continues to be the largest concern for cath lab operations, contributing factors for volume growth are clearly discernible. As future data becomes available to compare and contrast the benchmarked areas of revenue, expenses, company culture and facility outlook, it is our goal to mark industry trends and shins through the active participation of industry-leading professionals. To participate in future surveys, please contact Springboard HealthCare (https://www.springboardstaffing.com).