mitted volume. The other significant component if you're leasing or
buying, is the maintenance contract. Depending on the manufacturer,
you'll likely have a 12- or 18-month warranty. After that, a service con-
tract might be $40,000 or $45,000 annually. Other costs aren't nearly as
significant, for the most part. The additional property and casualty
insurance is likely to be $4,000 or $5,000 a year. If you're paying a
technician $30 an hour in salary and benefits and can do 2 femtolaser
cases an hour, labor costs are only about $15 per hour.
5.What about facilities that are already offering other premium
services?
Even if you've already successfully integrated toric lenses, presby-
opia-correcting lenses, refractive surgery, LASIK and PRK, and femto
is going to be just another offering, it still doesn't make a lot of sense
to start out by buying, given what manufacturers are offering. I'd rec-
ommend entering into a lease for 6 months to a year. You still need to
know you can get to 25 or so procedures a month. Once you're satis-
fied you can, then it might make sense to purchase the equipment.
6.If I know I have the patient volume, what are the advantages and
disadvantages of buying vs. leasing?
With a capital lease, the difference between leasing and buying really
comes down to who's going to lend you the money. Really, there's no
fundamental difference between getting the money from a bank and
getting it from a leasing company. Either is going to want to make a
market rate of return. You can get into some pretty esoteric tax argu-
ments between purchasing and leasing, but those are unpredictable
and depend on the tax situation of the borrower or lessor. In most
cases tax implications will be relatively minimal.
With a capital lease, there's usually a $1 buyout at the end of the
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | January 2015
