Healthcare — Imaging, surgery centers and ancillary
Capital-heavy, utilization-driven, and priced on assumptions set when the equipment was bought.
A surgery center or an imaging site is a fixed cost with a door on it. Nearly every decision that matters — which cases, which payers, which implants, whose block time — was made once, against a utilization assumption, and the assumption is rarely tested against the schedule that actually ran.
block utilization
room turnover
case cost
implant carve-out
first-case on-time start
supply cost per case
payer mix
open negotiation
These are the terms the review uses with you. A page written for
healthcare generally would not contain any of them.
Where it concentrates here
Specific to imaging, surgery centers and ancillary, not to healthcare generally. Each is
concentrated — a single agreement, a single code, a single account nobody reviews
— which is why a sample of the operation tends to miss it and a full pass tends to
find it. They are not findings from a named engagement.
Block time held by surgeons who no longer fill it and released too late to be re-booked, so a room is staffed and supplied for a case that will not arrive.
Implant and high-cost supply carve-outs written into some payer contracts and not others, with the difference invisible at the point the case is scheduled.
Case costing built at the procedure code rather than at the case, so the outlier — longer room time, an extra tray, a second implant — is averaged away.
Out-of-network claims where the window to initiate independent dispute resolution passes on the ones that would have been worth disputing.
Anaesthesia stipends and management or billing company fees agreed at opening and tied to a case volume that has since moved in one direction or the other.
Where this data actually lives
HST Pathways or Surgical Information Systems for scheduling and the case record; Vision or Nextech in single-specialty centers
A materials and preference-card system that knows what was opened and not what it cost
An outsourced billing or RCM provider holding the AR, reporting collections and rarely reporting denials by reason
PACS and RIS in imaging, separate from anything that prices a study
Named because it changes what the intake asks
for. An extract from one of these has known gaps, and the review is built around them
rather than surprised by them.
The proposal is written for healthcare as a
whole — the sequence, what we would need from you, and what it costs for your
number of operating units. What is on this page is what we would additionally expect to
find in imaging, surgery centers and ancillary.