Adding retina surgeon to ASC requires specific considerations
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TAMPA, Florida — At the Telling It Like It Is meeting here, John W. Kitchens, MD, shared factors to consider when adding a retina specialist to an ASC.
“Keep in mind when you’re thinking about having retina doctors operate in your surgery center, 90% of what we see on a daily basis are nonsurgical,” Kitchens said. “But still we see such a high volume of patients that of the 10% or less that are surgical, we will be able to bring cases. I feel like a full-time retina surgeon should probably be generating between four and 12 cases a week.”
The No. 1 question Kitchens hears about adding a retina surgeon to an ASC is how much it will cost. Adding a vitrectomy machine, microscope, wide-angle viewing system and other miscellaneous equipment would total between $135,000 and $500,000. Disposable equipment would cost between $515 and $715 per surgical case.
The unknown costs involved are indirect costs such as staff salaries and surgeon efficiency.
“This is probably one of the most critical factors when you are choosing whether to partner with a retina surgeon in your surgery center,” Kitchens said.
Kitchens noted that salaries have gone up 50% since the pandemic began.
“Salaries are becoming much more of an issue and creating a different dynamic in the operating room as far as bringing retina in and adding additional lines of service,” he said.
Still, surgical efficiency is the biggest component in this equation, Kitchens said.
He said that at current reimbursement rates, an ASC should expect to be paid about $2,000 per retina case.
“When we think about all of this, we have to integrate everything. We have to think about what’s going to be the capital, what is going to be the volume. That will give you an idea, that if you are going to do 400 cases in a year, you are going to pay off your capital pretty quickly if you have an efficient surgeon,” he said.
“If you have an efficient surgeon, your profit can be anywhere between $300 to $800 per case, depending on how much equipment is used. And you can expect if you have an efficient operating room and an efficient surgeon, you can get upwards of seven or eight surgeries done in a half day,” he said.
He also noted that a source of friction in the ASC is that 20% of retina cases are urgent, which can be disruptive to the flow of the ASC.
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Kitchens J. Integrating retina into an anterior segment surgery center. Presented at: Telling It Like It Is; Feb. 15-19, 2023; Tampa, Florida.
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