The clinical and financial impact of establishing an office-based vein center within an academic medical system

<h2>Abstract</h2><h3>Background</h3> Minimally invasive venous treatments and declining professional reimbursement have shifted superficial venous care from hospitals to office-based practices. This study evaluated the clinical and financial impact of establishing a freestanding, office-based vein center (VC), within an academic medical system. <h3>Methods</h3> A retrospective cohort study was conducted comparing venous services performed by vascular surgeons at an outpatient hospital (OH) facility and at a freestanding office-based vein center (VC). In 2018, venous patients were transitioned from the OH to the VC. OH data from October 1, 2016, to September 30, 2017, were compared with VC data from October 1, 2022, to September 30, 2023. Data collected targeted clinical volume (office visits, vascular lab studies, procedure volume), procedural efficiency (in-facility times) and financial performance (total clinical revenue, net operating margin). <h3>Results</h3> Venous procedures increased by 125%, from 317 at the OH to 713 at the VC; the VC procedures were generated from 3122 clinic visits and 1735 vascular lab studies performed at the VC. Average in-facility time decreased by 73% for endovenous ablation (244 to 65 minutes) and 79% for ambulatory phlebectomies (420 to 87 minutes) when comparing VC with OH. Net operating margin at the VC was $365,955 (18.9% of total revenue), reflecting a total revenue of $1,931,516 and total costs of $1,565,561. <h3>Conclusions</h3> Establishing an office-based vein center within an academic medical system led to higher clinical volume, enhanced efficiency, and positive net operating margin. Vascular surgeons should seek out opportunities to be clinical leaders and financial stakeholders in sites of service outside of traditional hospital settings.