annual maintenance costs. The surgeons knew they'd need to perform
11 cases a month to break even over the 5-year finance term. They've
blown that projection away by more than 250 cases per month.
The Delray Beach Surgery Center began leasing a femtosecond laser
nearly 3 years ago and has plans to buy it outright when the lease ends
in a couple of months. "We added the technology because we were
afraid we'd lose patients if we didn't offer it," says Ms. Cappella. She
can't pad facility fees for procedures involving the laser, so her center
doesn't make money off the technology. In fact, she charges surgeons
$700 each time they use the laser to recoup associated expenses.
Ms. Cappella opted to lease, but outsourcing laser technology or
standard cataract equipment is a viable option for facilities without
the case volume to fully support a cataract service line. About 1 in 10
(9.7%) of our survey's respondents work with an outsourcing firm,
which isn't that surprising considering we targeted facilities with
established cataract programs. Half of the facilities that do outsource
are very satisfied with the arrangement, according to the survey.
Dorothy Zimdahl, RN, BS, CNOR, CASC, administrator of the eye-
only ASC of Niagara in Niagara Falls, N.Y., looked into outsourcing
cataract equipment when she worked at an acute care hospital.
Although the hospital couldn't meet the minimum amount of cases
the outsourcing firm required to bring equipment in, Ms. Zimdahl
sees the potential benefit of using an outside service. She recently
spoke with leaders at an orthopedic-focused center who were con-
sidering adding cataracts to their case mix. "It'd be an ideal fit for
them," she says. "They could try out procedures with no commit-
ment and see if they have the staff and surgeons to turn cases fast
enough to eventually buy their own equipment."
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