Stand-alone surgical centers in York County showed slight improvements in their financial margins for fiscal year 2011.

That's according to a report released this week by the Pennsylvania Health Care Cost Containment Council (PH4C).

Of the 12 surgical centers in York, Apple Hill Surgical Center had the highest revenue for 2011 at $13.82 million.

The other centers in York County are Elmwood Endoscopy Center, Eyes of York Surgical Center, Foot and Ankle Surgical Center, Hanover Surgical Center, Hillside Endoscopy, Leader Surgical Center, Memorial Outpatient Endoscopy, Surgical Center of York, WellSpan Surgical Center, York Endoscopy and York Pain Specialists.

Between fiscal years 2000 and 2009, the number of surgery centers in Pennsylvania increased from 72 to 262, an average increase of 21 per year. During fiscal year 2010, there was a net increase of four surgical centers.

In fiscal year 2011, five more surgery centers were added in Pennsylvania

and none closed, bringing the state total to 271.

The financial margins for surgery centers continued to increase in 2011, but the number of facilities did not grow as rapidly as it had in the last decade, said Joe Martin, executive director of PH4C.

"It is hard to say whether that is just an aberration and we will see another significant increase next year, or if it is a sign that the market is kind of leveling out," Martin said.

Surgical centers are outpatient facilities that offer patients a place to have surgery in a stand-alone facility rather than a hospital operating room.

Efficiency: The increase in surgical centers has been driven by customer desire for efficiency, convenience and specialization, said Barry Sparks, spokesman for WellSpan, which has operated Apple Hill Surgical Center since 1988 and WellSpan Surgical Center since 2009.

"Ambulatory surgery centers also have proven to be a profitable venture for most providers," Sparks said.

The centers create a leaner infrastructure for surgeons and staff, and provide a surgical environment designed for efficiency and convenience for patients who do not require an overnight stay, Sparks said.

No new surgical centers were built in York in fiscal year 2011, but the number of patient visits to the centers in York remained steady.

Access and convenience are two major advantages of surgical centers, said Josette Myers, spokeswoman for Memorial Hospital, which operates the Memorial Outpatient Endoscopy Center and the Surgical Center of York.

"Surgical centers are typically smaller than hospitals, which makes them easier to navigate through. Patients are not being co-mingled with sicker, more urgent cases that are being taken care of in the hospital," Myers said.

Surgical Center: The Surgical Center of York had a negative 8.22 percent for the three-year average change in net patient revenue from fiscal year 2008 to fiscal year 2011. In fiscal year 2008 its revenue was $4.158 million, and by fiscal year 2011 it was down to $3.132 million.

The opening of OSS Health affected the Surgical Center of York because many of those surgeons previously did a lot of work at the Surgical Center, Myers said.

"Over the past few years, we have started to and continue to recruit other specialists who can perform work at the Surgical Center to fill that volume," said Myers.

More patients: Three centers in York -- Apple Hill, York Endoscopy and York Pain Specialists -- reported a higher number of patient visits in fiscal year 2011 than the state average of 4,066.

Surgical centers in Pennsylvania reported more than 1 million outpatient visits in fiscal year 2011, an increase of 0.7 percent from the previous year.

The procedures at surgical centers were 32.5 percent of the total outpatient procedures in Pennsylvania, with the remainder performed at general acute care hospitals.

-- Reach Chelsea Shank at 505-5432 or cshank@yorkdispatch.com