Data & Insights: Ophthalmology

Leveraging data in every aspect of operations is now essential for long-term success.

Ophthalmology remains a cornerstone of ASC profitability, with high case volumes and consistent reimbursement rates. As demand for cataract and refractive surgeries rises, ASCs must optimize operational efficiency, case throughput, and supply costs to sustain growth. Tracking the right KPIs ensures centers stay competitive while delivering top-tier patient care. Explore the latest ophthalmology trends below.

This data represents 416,817 unique cases across 214 centers.

OR Block Utilization

OR utilization declined from 58% to 54%, signaling potential inefficiencies.

Seamless communication between a doctor’s office and the ASC is key to driving case volume. Avoid phone and fax delays—use technology to broadcast OR availability, enable electronic scheduling, and automate block time management to improve efficiency and achieve at least 70% utilization.

Pre-Authorization Rates

Pre-auth approvals dipped slightly, dropping from 15% to 14%.

Obtaining prior authorization prevents denials and reimbursement delays. ASCs should verify authorizations secured by the doctor’s office to avoid performing procedures without approval. Leveraging integrated payer technology streamlines the process, reducing administrative burden and ensuring compliance.

Insurance Verification Rate

Verification rate climbed from 83% to 88%, outperforming industry norms.

Verifying insurance eligibility prevents financial issues and last-minute cancellations. ASCs should re-verify coverage twice—upon case acceptance and the morning of surgery—and re-run checks monthly to catch lapses. Automating this process minimizes manual work and ensures seamless patient care.

Case Cancellation Rates

Slight increase—cancellation rate rose a bit from 14.7% to 15.4%.

Maintaining communication with patients, physicians, and vendors keeps cases on track and prevents last-minute cancellations. A centralized system allows the care team to coordinate seamlessly, share updates, and address issues early. Proactive patient communication also reduces the risk of patient-initiated cancellations.

Case Cancellation Reasons

Patient decisions led 36% of cancellations, with provider cancellations at 27%.

Some case cancellations are unavoidable, but many can be reduced with better processes. Issues like missing labs, scheduling errors, and surgery center inefficiencies are within your control. Analyzing cancellation reasons helps identify areas for improvement, keeping your schedule optimized and reducing lost revenue.

Patient Deposit Collection Rate

More patients are paying upfront—collection rates rose from 79% to 83%.

Surgery costs can be overwhelming for patients. Providing accurate estimates 1-2 weeks before their procedure builds trust, reduces cancellations, and improves satisfaction. Using technology, ASCs can generate clear, easy-to-read estimates, send them via text or email, and enable upfront payments.

Days to Bill

Faster turnaround—billing time improved from 8 to 6 days.

Accurate coding and charge entry are essential for reimbursement and compliance. Integrating EHR and billing systems reduces errors and streamlines the process. Using well-trained coders and tracking denials helps prevent mistakes, improving financial health and operational efficiency.

Claim Denial Rate

Denial rate rose from 7% to 9%, signaling potential reimbursement hurdles.

Efficient claim management is essential for maintaining cash flow and compliance. Using EHR, practice management, and electronic claims systems streamlines submissions and reduces errors. Regularly monitoring claims helps address denials quickly, ensuring timely reimbursement and sustaining operational efficiency.

Net Revenue Per Case

Positive trend—net revenue per case grew 7.6%, from $1,770 to $1,904.

Beyond patient outcomes, profitability is a top priority for ASCs. Monthly financial reviews help identify trends and address issues quickly. Using analytics tools and standardized reporting ensures data-driven decisions, improving revenue, controlling expenses, and maintaining long-term financial stability.

Case Volume

Strong growth—case volume increased by 9.4%, from 342 to 378 cases.

Tracking average case volume is essential for forecasting profitability, resource allocation, and expansion planning. Monitoring trends helps ASCs identify growth opportunities, adjust staffing, and optimize OR utilization to maintain efficiency and financial stability in a rapidly evolving healthcare landscape.

State of the Industry Report: Best Practices & Industry Benchmarks for Optimizing ASC Operations

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Benchmarks & data from 3 million cases

130+ KPIs to track

Best practices for the patient journey

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*Disclaimer: HST Pathways released an updated version of our State of the Industry Report in September 2024, highlighting best practices, key process steps, and KPIs for every step of the patient journey and for nearly every recurring administrative duty. Most importantly, using our own unique dataset from our clients, we were able to extract data points so that anyone in the industry could compare themselves to their peers. We only pulled data from clients who gave us permission, and we omitted any extreme outliers. Data on this page may differ from the full 2024 State of the ASC Industry report. The full report (published September 2024) included data through Q2 2024, while this page (published March 2025) includes data through Q4 2024. Differences are due to the extended timeframe and new data from clients who have since granted permission.

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