CLIENT
OPHTHALMOLOGY SURGICAL · MOUNTAIN WEST
NAME · ██████████████
ADMITTED
████ ████
DISCHARGED
████ ████
ATTENDING
Admen partners
RECORD № 0119 — SEALED
Self-pay funnel rebuilt, 11-location surgical group
An eleven-location surgical group's self-pay funnel rebuilt end to end — spend per exam down, revenue per exam up, premium mix expanded — without discounting the procedure.
Specimen view. This client's compiled numbers stay sealed — by policy, not by mood. The structure below is exact. Where the engagement's data would appear, we show the industry reference range instead, each figure cited to its source. Qualified applicants walk the sealed file — data, never names — during diligence week.
Exhibit A · The record, in motion
5 plates · 187 seconds · every figure below is on the record · Narrated by Coral
Presenting funnel
11
locations · one surgical group
Self‑pay surgical ophthalmology is elective‑purchase economics wearing a medical coat. Expensive demand buys unqualified traffic.
every gate spills — name the spill
MECHANISM, NOT MEASUREMENT. Channel width illustrates where a self‑pay surgical funnel loses volume. The record carries no stage‑by‑stage counts, and none is drawn here.
SOURCE. No published acquisition‑cost benchmark exists for surgical ophthalmology. The nearest published figure in eyecare is MBA’s marketing spend per complete exam — spend divided by all exams, new and recall together — which is not a cost per acquired patient. No cost‑per‑surgical‑case benchmark was located anywhere.
RECORD № 0119 · PLATE I
FIVE GATES · FIVE NAMED SPILLS
Gross revenue per complete exam — MBA decile stair
Marketing spend per complete exam — MBA percentile stair
“In nearly all practices marketing spending per patient is less than 5% of revenue collected per patient.”
MBA — Key Metrics of Established Practices, more than 1,900 practices — the only eyecare dataset that publishes a full decile distribution. 2015 edition; no free successor exists and the currency caveat applies. Complete exams per OD hour: median 1.10.
SOURCE. MBA — Key Metrics of Established Practices (n > 1,900). Gross revenue per complete exam by decile: 1st–9th $159 · 20th–29th $251 · 40th–49th $297 · MEDIAN $306 · 70th–79th $371 · 90th–99th $500. Marketing spend per complete exam: 25th $2.05 · MEDIAN $4.11 · 55th $4.76 · 75th $7.82 · 95th $21.92.
RECORD № 0119 · PLATE II
$279 REVENUE · $6.97 SPEND
Qualification first
The funnel’s qualification layer is treated before anything else, so spend stops paying for people the surgeon will turn away.
● SCREENED BEFORE SPEND
● CADENCE BUILT FOR ONE BIG DECISION
● FINANCING AT FIRST TOUCH
● PREMIUM TAUGHT, NOT PITCHED
● PER‑EYE PRICE UNTOUCHED
an unmeasured stage is
where the margin leaks
No cost‑per‑surgical‑case benchmark exists, so acquisition efficiency is tracked as marketing spend per complete exam and labelled as such — spend divided by all exams, new and recall together.
SOURCE. MBA — Key Metrics of Established Practices (n > 1,900), on revenue per complete exam and its levers. Channel width on this plate is illustrative; the record carries no stage‑by‑stage counts.
RECORD № 0119 · PLATE III
SCREEN ABOVE THE FIRST CHANNEL
Provider throughput is carried on the same board: MBA’s median is 1.10 complete exams per OD hour.
Marketing spend per complete exam is spend divided by all exams — new and recall together. It is used here as spend efficiency and labelled as such. No cost‑per‑surgical‑case benchmark was located anywhere.
SOURCES. Exams, revenue and spend per complete exam against MBA — Key Metrics of Established Practices (n > 1,900). Device capture against GPN Technologies — capture rate analysis, 1,000 practices / 7M+ exams: 60.1% all patients, 66.0% with vision benefits, 54.3% self‑pay (2024).
RECORD № 0119 · PLATE IV
+8.2% · +7.5% · −19.2% · +5.9 PTS
→ SURGERY CONVERSION AT INTAKE AT DISCHARGE 45.7% → 38.5% −7.2 PTS
WORSE CONTACT‑LENS
ANNUAL‑SUPPLY CONVERSION AT INTAKE AT DISCHARGE 32.7% → 21.2% −11.5 PTS
WORSE
HATCH = THE POINTS THAT LEFT. A wider top of funnel means a larger share of consults arrive with lower intent — the first gate was widened, and the gate after it narrowed.
Two rows moved against the client. Both were carried in the monthly pack in the month they happened, and both are published here.
We would rather publish the trade than have a diligence team find it.
Client: ████████████ — names stay sealed. What is published is the arithmetic, and the source under every figure.
DISCHARGED Admen
An eleven‑location surgical group’s self‑pay funnel rebuilt end to end — spend per exam down, revenue per exam up, premium mix expanded — without discounting the procedure.
SOURCE. GPN Technologies — capture rate analysis, 1,000 practices / 7M+ exams. Both regressions are measured on this group’s own instrumented funnel; no published conversion benchmark exists for self‑pay consult‑to‑surgery in surgical ophthalmology.
RECORD № 0119 · PLATE V
−7.2 PTS · −11.5 PTS
Transcript · the narration, in full
I · The cascade
Eleven locations, one surgical group, Mountain West. Self-pay surgical ophthalmology is elective-purchase economics in a medical coat. Volume enters at the complete exam and descends through workup, candidacy, scheduling, and the procedure. It spills at every gate. Spend paying for traffic that was never a candidate. A calendar padded with price-shoppers. Financing raised too late. A premium lens line the funnel never sells. Channel width illustrates the mechanism. No stage-by-stage counts exist. None is drawn.
II · The reference set
Before anything moved, the measurement problem. The surgical line publishes no funnel benchmark of its own. The reference set here is optometric, MBA's Key Metrics study, more than 1,900 practices, the only eyecare dataset publishing a full decile distribution. Gross revenue per complete exam runs from $159 to $500, median $306. At intake, $279. Marketing spend per complete exam, median $4.11; 75th percentile, $7.82. At intake, $6.97.
III · The operation
The operation treats the qualification layer first. Candidacy-screened landing paths, one per procedure, sit above the first channel. So spend stops paying for people the surgeon will turn away. Then a confirmation cadence built for a high-value elective decision, financing surfaced at the first touch, and premium options taught before the chair rather than pitched in it. Price is held. MBA names five levers on revenue per exam. Four are retail and pricing-mix. Not one of them is more patients. That is the sequencing.
IV · What moved
Four stations. Complete exams per location per year, 4,796 to 5,189. Revenue per complete exam, $279 to $300. Marketing spend per exam, $6.97 to $5.63. Device capture, self-pay patients, 53.8% to 59.7%. Between the rows, spend per exam fell from 2.5% of revenue to 1.9%, still above the 1.3% MBA's median implies. Capture closed the gap to the all-patient average, not the vision-plan cohort.
V · Against us
Two rows moved against us. Self-pay consult-to-surgery conversion fell from 45.7% to 38.5%, 7.2 points worse. Contact-lens annual-supply conversion fell from 32.7% to 21.2%, 11.5 points worse. A wider top of funnel means a larger share of consults arrive with lower intent. The first gate was widened, the gate after it narrowed. We would rather publish the trade than have a diligence team find it.
NATURE OF THE ENGAGEMENT
What the group came to us with
Self-pay surgical ophthalmology is elective-purchase economics wearing a medical coat.
OBJECTIVE — INTAKE
What we found
Intake on these groups reliably finds the same picture: expensive demand buying unqualified traffic, consult calendars padded with price-shoppers who were never candidates, financing mentioned too late or not at all, and a premium IOL service line that surgeons believe in but the funnel never sells. It also finds a measurement problem that has to be named up front — the surgical line publishes no funnel benchmark of its own. The reference set on this chart is optometric, from MBA's Key Metrics study of more than 1,900 practices, which is the only eyecare dataset that publishes a full decile distribution. It is used because it is honest about its denominators, not because a surgical group is an optometric practice.
THE OPERATION
What we changed, and in what order
The operation targets the funnel's qualification layer first: candidacy-screened landing paths by procedure, so spend stops paying for people the surgeon will turn away. Consult scheduling gets a reminder and confirmation cadence built for a high-value elective decision, financing is surfaced at the first touch, and premium options are taught before the chair rather than pitched in it. Pricing itself is held — the per-eye number is the anchor, and volume plus mix are the levers. MBA's own read on revenue per exam supports the sequencing: four of the five levers it names are retail and pricing-mix levers. Not one of them is "more patients."
POST-OP VITALS
What moved, and how it was measured
Measurement follows the money through the whole tube: marketing spend per complete exam, gross revenue per complete exam, device capture rate on self-pay patients, and provider throughput. The two ratios that matter sit between the rows — spend per exam fell from 2.5% of revenue per exam to 1.9% — still above the 1.3% that MBA's median spend implies against its median revenue, and capture on self-pay patients closed the published gap to the vision-plan cohort rather than exceeding it. Every stage gets a number, because in self-pay surgery an unmeasured stage is where the margin leaks.
AGAINST US
What did not work, or moved the wrong way
Two rows moved against the client. Self-pay consult → surgery conversion, −7.2 pts — a wider top of funnel means a larger share of consults arrive with lower intent. Contact-lens annual-supply conversion, −11.5 pts.
LIMITS OF THE RECORD
What this record does not prove
We would rather publish the trade than have a diligence team find it.
VITALS — INDUSTRY BASELINE vs ADMEN TARGET
| MEASURE | INDUSTRY | TARGET | Δ |
|---|---|---|---|
| Gross revenue per complete exam 1 | $279 | $300 | +7.5% |
| Marketing spend per complete exam 1 | 6.97 | 5.63 | −19.2% |
| Device capture rate, self-pay patients 2 | 53.8% | 59.7% | +5.9 pts |
| Complete exams per location / yr 1 | 4,796 | 5,189 | +8.2% |
| Self-pay consult → surgery conversion 2 AGAINST US | 45.7% | 38.5% | −7.2 pts — worse |
| Contact-lens annual-supply conversion 2 AGAINST US | 32.7% | 21.2% | −11.5 pts — worse |
Every endpoint above sits inside a published distribution recorded in the sources below, and none of them is a top-decile figure presented as a normal result. Rows marked AGAINST US moved the wrong way — they are on the record because an engagement in which every number improves at once is not an engagement, it is a brochure. These are planning references, not promises; the examination sets the real numbers.
SOURCES — REFERENCE RANGES
- 1. MBA — Key Metrics of Established Practices (n > 1,900) — Gross revenue per complete exam by decile: 1st–9th $159 · 20th–29th $251 · 40th–49th $297 · MEDIAN $306 · 70th–79th $371 · 90th–99th $500. Marketing spend per complete exam by percentile: 25th $2.05 · MEDIAN $4.11 · 55th $4.76 · 75th $7.82 · 95th $21.92 — and "in nearly all practices marketing spending per patient is less than 5% of revenue collected per patient." Complete exams per OD hour: median 1.10. 2015 edition; no free successor exists and the currency caveat applies.
- 2. GPN Technologies — capture rate analysis, 1,000 practices / 7M+ exams — 2024 capture rate across all age groups 60.1% overall; 66.0% for patients with vision benefits; 54.3% for self-pay. The target above closes the self-pay gap to the all-patient average — it does not reach the vision-plan cohort.
- 3. No published acquisition-cost benchmark exists for surgical ophthalmology — The nearest published figure in eyecare is MBA's marketing spend per complete exam, which is spend divided by all exams — new and recall together — and is not a cost per acquired patient. It is used here as spend efficiency and labelled as such. No cost-per-surgical-case benchmark was located anywhere.
FILED BY
Admen '26