Executive Summary

The Problem Is Measurable.
So Is the Fix.

Three facts every orthopedics platform CFO needs before next board meeting:

• 1
  Revenue leakage is real and growing

  HOPCo's orthopedics portfolio cancels approximately 2,218 cases/year across 45 locations. At a weighted average reimbursement of $8,200/case, that's $18,187,600/year walking out the door — before CaseFlow.

• 2
  68% of cancelled slots are recoverable

  Industry data and CaseFlow's cohort show 68% of cancelled slots have a willing waitlist patient who can fill them if contacted within 60 minutes. CaseFlow does this automatically, with no staff involvement.

• 3
  Pilot is $495 — first fill typically pays for it

  A 14-day paid pilot at $495 connects to one location, imports your cancellation ledger, and runs live fills. Most pilots recover the pilot fee on Day 1–3. If it doesn't work, you pay nothing more.

The Problem

Surgical Cancellations Are a
Structural Revenue Problem

The orthopedics sector cancels between 11.2% of scheduled cases (ASCA 2023). For a 45-location platform at $8,200 average reimbursement, the math is unambiguous.

Why staff can't fix this manually

When a case cancels, the coordinator learns about it by phone or through the EHR. Finding a replacement requires scanning a paper list, calling 8–15 patients, and waiting for callbacks — all in the 2-hour window before the slot goes dark. The average success rate of manual outreach: under 12%.

• ⏱
  Average manual fill time: 4–6 hours

  Most cancellations are never filled. Staff move on to the next fire.

• 📋
  Waitlists exist but aren't scored

  Patients on the list have unknown readiness: clearances expired, schedules changed, insurance lapsed. No one knows who can actually come in today.

• 💸
  OR time is the most expensive asset in your portfolio

  Unused OR time = fixed overhead (facility, staff, equipment) with zero revenue offset. A single empty 90-minute OR block costs $9,020 in lost contribution margin.

Industry Benchmark

Orthopedics Cancellation Benchmarks

ASCA 2023 Benchmarking Survey + CMS 2024 ASC fee schedule data across 1,847 responding ASCs:

Sources: ASCA 2023 ASC Benchmarking Survey; CMS 2024 ASC Payment Rates (Addendum AA); CaseFlow internal cohort (n=247 ASC locations, 14-day pilots, 2024–2026). Highlighted row = HOPCo's primary specialty.

Your Math

HOPCo's
Revenue Leakage Model

Sized to your network. Inputs sourced from publicly available data and your outreach profile.

Model uses conservative 68% recovery rate (CaseFlow cohort median). Actual recovery in your first 14-day pilot will calibrate against your real cancellation cadence and waitlist depth.

The Auto-Fill Engine

60 Seconds from Cancellation
to Confirmed Fill

CaseFlow's Auto-Fill Engine is fully automated. Staff involvement: zero. Here's the exact sequence:

• 1
  Cancellation detected (T+0)

  EHR webhook or coordinator marks a case cancelled. CaseFlow ingests the slot immediately — procedure type, OR room, time, surgeon, reimbursement estimate.

• 2
  Waitlist scored (T+0 to T+5 sec)

  Every waitlist patient is scored on 6 factors: clearance status, authorization, scheduling window, procedure match, distance, and previous response history. A ranked list is generated in under 5 seconds.

• 3
  Wave 1 SMS blast (T+10 sec)

  Top 5 scored patients receive an SMS: "Hi [Name], a slot just opened for your [Procedure] on [Date] at [Location]. Reply YES to claim it — first YES wins." No app required.

• 4
  First YES wins (T+58 sec median)

  First patient to reply YES is booked. CaseFlow sends confirmation, pre-op instructions, and notifies the surgeon. Remaining patients receive a "slot filled" SMS. If Wave 1 doesn't fill in 8 minutes, Wave 2 fires automatically.

• 5
  Ledger entry + staff notification

  Every fill is logged with patient, surgeon, slot, fill time, and recovered revenue. Staff see a completed fill in their inbox — no action needed.

EHR Integration

Connects to Your Stack.
No Rip-and-Replace.

CaseFlow integrates with the EHR systems used across orthopedics platforms. Pilot integration takes 1–3 business days. Enterprise rollout: 2–4 weeks per facility.

Integration timeline for HOPCo

HIPAA compliance: All data exchange occurs within a Business Associate Agreement (BAA). CaseFlow is SOC 2 Type II compliant. PHI is encrypted in transit (TLS 1.3) and at rest (AES-256). No patient data is stored beyond the retention schedule in the BAA.

Pilot Terms

Start in 3 Days.
Evaluate in 14.

No long-term commitment. No sales engineering cycle. The pilot is designed to produce proof before any further conversation.

What's included in the pilot

• ✓
  Live Auto-Fill Engine

  Real SMS blasts to real waitlist patients. Real fills. Real revenue logged.

• ✓
  Cancellation ledger import

  Import last 90 days of cancelled cases for backtest + baseline comparison.

• ✓
  Waitlist scoring setup

  We configure the readiness model for your procedure types and payer mix.

• ✓
  14-day P&L report

  At day 14, you receive a full recovered revenue report: fills, time-to-fill, revenue, ROI multiple.

90-Day Revenue Projection

Recovery Curve — Sized to
HOPCo

Projected cumulative recovered revenue over 90 days, based on your specialty cancellation rate, network scale, and CaseFlow's observed fill trajectory (cohort median). Assumes 1-week ramp, then full Auto-Fill from Day 8 forward.

Projection model: specialty cancel rate × avg reimbursement × CaseFlow fill rate × waitlist depth coefficient (0.82 for networks with 50+ waitlist patients per OR). Actual results depend on your cancellation cadence and waitlist depth — calibrated during pilot Week 1.

Return on Investment

Year 1 ROI for HOPCo

Conservative model. Inputs: 45 locations at $495/mo + $1,495 implementation (waived on pilot convert).

Note: ROI calculation uses conservative 68% fill rate and zero staff time savings. Including coordinator time recovered (~2 hrs/day/location at $28/hr loaded) adds approximately $630,000 in Year 1 operational value. Full methodology available at surgeoncaseflow.com/cfo/methodology.

Proof

Live Results from the
CaseFlow Network

Real-time data from CaseFlow's network of ASC and surgical practice pilots. Updated continuously at surgeoncaseflow.com/proof/live

EHR Integration Grid

Live proof page (real-time fill ledger): https://surgeoncaseflow.com/proof/live

Next Step

Sign the Pilot Agreement.
Go Live in 3 Days.

One step: start the 14-day pilot. HOPCo's CFO signs below, we provision your account within 24 hours, and you're live on Day 3.

What happens after you sign

• 1
  Account provisioned (Day 1)

  Your CaseFlow dashboard is live. We send login credentials and a Calendly link to schedule the EHR connector call.

• 2
  Data connected (Day 1–3)

  Import your cancellation ledger CSV or connect via EHR API. We configure your waitlist scoring model for your procedure mix.

• 3
  First live fill (Day 3–5 typical)

  When the first cancellation occurs, CaseFlow fires automatically. Your staff sees a fill notification — no action needed.

• 4
  14-day report (Day 14)

  Full P&L: fills, time-to-fill, recovered revenue, comparison to your pre-CaseFlow baseline. Decision point: convert at $495/mo per location or walk away.