CLIENT
OPTOMETRY / OPHTHALMOLOGY · SOUTHEAST
NAME · ██████████████
ADMITTED
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DISCHARGED
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ATTENDING
Admen partners
RECORD № 0184 — SEALED
Off exam-volume economics, onto elective mix
Nineteen locations moved off exam-volume economics by repricing the elective mix — capture rate and revenue per exam, not more bodies through the door.
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 · 165 seconds · every figure below is on the record · Narrated by Coral
One revolution = $500 = MBA 90th–99th decile
Presenting complaint
Plenty of exams. Thin revenue per exam. The hand is short not because the chairs are empty — it is short because of what happens once the patient is in one.
At admission
$299
Gross revenue per complete exam
Locations · one tick each
The published spread, bottom decile to top
$159 → $500 3.1×
Same measure, same publisher. And only a weak positive correlation between practice size and revenue per exam.
the group is busy. busy is not the same as healthy.
SOURCE. MBA — Key Metrics of Established Practices, n > 1,900. Gross revenue per complete exam: 30th–39th $276 · MEDIAN $306 · 60th–69th $341 · 90th–99th $500. Bottom-decile $159 to top-decile $500 is the 3.1× spread. 2015 edition; currency caveat applies.
RECORD № 0184 · PLATE I
OPTOMETRY / OPHTHALMOLOGY · SOUTHEAST
Inside the face: this group. Outside: the top decile’s lap.
“does not vary significantly by practice size.”
MBA, on this exact ratio
At admission
52
Eyewear Rxes per 100
complete exams
30TH–39TH 54 · MEDIAN 61 · 60TH–69TH 68 · 90TH–99TH 109
Nineteen locations of scale does not put the hand there. The ratio is indifferent to how many chairs a group owns — which makes this an operating problem.
you cannot buy your way onto this ratio
SOURCE. MBA — Key Metrics of Established Practices, n > 1,900. Eyewear Rxes per 100 complete exams: 30th–39th 54 · MEDIAN 61 · 60th–69th 68 · 90th–99th 109. The publisher’s own note on this row: it “does not vary significantly by practice size.” 2015 edition.
RECORD № 0184 · PLATE II
52 PER 100, AT ADMISSION
Sand = at admission · red = the gain · pins = published percentiles
38.3% → 50.2% +11.9 pts
MBA · 30TH–39TH 40% · AVERAGE 43% · 50TH–59TH 45% · 90TH–99TH 62%
42.1% → 50.5% +8.4 pts
NO PUBLISHED PERCENTILE LADDER ON THIS ROW — THE RING CARRIES NO PINS
4.2% → 6.9% +2.7 pts
MBA · 25TH 5% · MEDIAN 10% · 95TH 33% — SIZING: 10% → 15% IS WORTH 1–2% OF PRACTICE REVENUE
recall cadence rebuilt — the base compounds instead of churning
SOURCES. MBA — Key Metrics of Established Practices, n > 1,900 (rings A and C). GPN Technologies — capture rate analysis, 1,000 practices / 7M+ exams (dashed outer ring only). No published ladder exists for contact-lens annual-supply conversion, so ring B carries no pins.
RECORD № 0184 · PLATE III
THREE RINGS · ONE REVOLUTION = 100%
Measurement centres on per-exam economics, and the rows are built so they close on each other. Four dials go in; the fifth is what they produce.
$341
Gross revenue per
complete exam · 60th–69th
one revolution = $500
45%
Eyewear share of gross
revenue · 50th–59th
one revolution = 100%
$153
Eyewear revenue
per complete exam
one revolution = $500
68
Eyewear Rxes per 100
complete exams · 60th–69th
one revolution = 100
$226
Retail per Rx
red pin = median retail
sale per pair, $227
The table closes on itself to a dollar. That is the point of using it — and the reason the group’s own row is reported against it rather than in place of it.
SOURCE. MBA — Key Metrics of Established Practices, n > 1,900: 60th–69th revenue per complete exam $341 · 50th–59th eyewear share 45% · 60th–69th Rxes per 100 exams 68 · median retail sale per pair $227. 2015 edition.
RECORD № 0184 · PLATE IV
$226 AGAINST $227
What moved
$299 → $324
+8.4%
Gross revenue per complete exam
one revolution = $500
$36 → $31
−13.9%
Cost per complete exam booked
one revolution = $50
Nineteen locations moved off exam-volume economics by repricing the elective mix — capture rate and revenue per exam, not more bodies through the door.
Against us — same table, same weight
Ghost hand = at admission · red hand = at discharge · the red arc is travelled anticlockwise
5,101 → 4,902
−3.9% · worse
Complete exams per
location / yr · rev = 6,000
25.2% → 17.5%
−7.7 pts · worse
Premium-lens attach
rate · rev = 100%
52 → 48
−7.7% · worse
Eyewear Rxes per 100
complete exams · rev = 100
The group moved off exam-volume economics on purpose. A chosen trade is still a trade, and it sits here rather than in a footnote.
Client: ██████████████
Admen ’25NO PUBLISHED BENCHMARK EXISTS for cost per complete exam booked. The closest optometry publishes is MBA’s marketing spend per complete exam — median $4.11, ≈1.3% of the $306 median revenue per exam — spend over all exams, new and recall alike. It is not an acquisition cost and no dial here treats it as one. Premium-lens attach: GPN Technologies, 1,000 practices / 7M+ exams.
RECORD № 0184 · PLATE V
DISCHARGED
NATURE OF THE ENGAGEMENT
What the group came to us with
Optometry groups with an ophthalmology arm usually arrive anemic in a specific way: plenty of exams, thin revenue per exam.
OBJECTIVE — INTAKE
What we found
The optical capture rate — the share of exam patients who buy their eyewear in-house — has never been measured, elective services are priced apologetically or buried, and the handoff between the OD side and the MD side leaks surgical candidates to competitors. MBA's decile table is the argument for treating this as an operating problem rather than a scale problem: revenue per complete exam runs from $159 at the bottom decile to $500 at the top, a 3.1× spread, and the publisher records only a weak positive correlation between practice size and revenue per exam. The group is busy. Busy is not the same as healthy.
THE OPERATION
What we changed, and in what order
The operation reprices the mix rather than chasing raw exam volume. Capture rate gets instrumented per location so walkouts become a visible, ownable number. Elective and medical service lines get distinct positioning, pricing architecture and demand paths — cataract and surgical referrals out of the group's own chairs are the cheapest demand it will ever generate. Recall and reminder cadence is rebuilt so the existing patient base compounds instead of churning. Second-pair sales are treated as a discipline rather than a discount: MBA's own sizing is that moving the multiple-pair ratio from 10% to 15% is worth 1–2% of practice revenue, and this group started at 5%.
POST-OP VITALS
What moved, and how it was measured
Measurement centres on per-exam economics, and the rows are built so they close on each other. At discharge, revenue per complete exam of $341 at a 45% eyewear share gives $153 of eyewear revenue per exam; divided by 68 eyewear Rxes per 100 exams, that is $226 of retail per Rx — one dollar under MBA's published median retail sale per pair of $227. The endpoint on this chart is not more patients. It is more practice per patient, at every one of the nineteen locations, and it stops short of the top decile on every line.
AGAINST US
What did not work, or moved the wrong way
The cost side, stated rather than buried: Complete exams per location / yr, −3.9% — the group moved off exam-volume economics on purpose — a chosen trade is still a trade. Premium-lens attach rate, −7.7 pts. Eyewear Rxes per 100 complete exams, −7.7%.
LIMITS OF THE RECORD
What this record does not prove
These sit in the same table as the wins, at the same weight, because moving them to a footnote is how a case study becomes an advertisement.
VITALS — INDUSTRY BASELINE vs ADMEN TARGET
| MEASURE | INDUSTRY | TARGET | Δ |
|---|---|---|---|
| Gross revenue per complete exam 1 | $299 | $324 | +8.4% |
| Second-pair sales ratio 1 | 4.2% | 6.9% | +2.7 pts |
| Eyewear share of gross revenue 1 | 38.3% | 50.2% | +11.9 pts |
| Contact-lens annual-supply conversion 2 | 42.1% | 50.5% | +8.4 pts |
| Cost per complete exam booked 3 | $36 | $31 | −13.9% |
| Complete exams per location / yr 1 AGAINST US | 5,101 | 4,902 | −3.9% — worse |
| Premium-lens attach rate 2 AGAINST US | 25.2% | 17.5% | −7.7 pts — worse |
| Eyewear Rxes per 100 complete exams 1 AGAINST US | 52 | 48 | −7.7% — 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: 30th–39th $276 · MEDIAN $306 · 60th–69th $341 · 90th–99th $500. Eyewear Rxes per 100 complete exams: 30th–39th 54 · MEDIAN 61 · 60th–69th 68 · 90th–99th 109 — and the ratio "does not vary significantly by practice size." Second-pair ratio: 25th 5% · MEDIAN 10% · 95th 33%. Eyewear as a share of gross revenue: 30th–39th 40% · AVERAGE 43% · 50th–59th 45% · 90th–99th 62%. Median retail sale per pair $227. 2015 edition; currency caveat applies.
- 2. GPN Technologies — capture rate analysis, 1,000 practices / 7M+ exams — Independent corroboration of the capture-rate direction from a second installed base: 60.1% overall in 2024, 66.0% with a vision plan, 54.3% self-pay. Different denominator from MBA's Rx-per-exam ratio — recorded alongside, never merged with it.
- 3. MBA — marketing spend per complete exam — Median $4.11 per complete exam, or roughly 1.3% of the $306 median revenue per exam. This is spend over all exams, new and recall alike, and is the closest thing optometry publishes to an acquisition cost. It is not one, and no row above treats it as one.
FILED BY
Admen '26