{
  "slug": "healthcare",
  "label": "Healthcare",
  "publisher": "Level",
  "publisher_url": "https://levelcfo.com",
  "dataset": "The Level Index, Healthcare benchmarks",
  "methodology": "Aggregated from public industry and government sources plus the Level founding team's contractor analysis. Percentile distributions where available, otherwise category anchors. No individual company is identified.",
  "sources": [
    "MGMA DataDive (medical group medians)",
    "HFMA MAP Award Statistical Appendix 2024",
    "ADA Health Policy Institute Survey of Dental Practice 2024",
    "AMA Physician Practice Index 2024",
    "BLS Occupational Employment & Wages 2023-2024",
    "KFF analysis of CMS QHP transparency files 2024",
    "Level Index, the founding team's analysis of 2,200+ contractors ($13.25B revenue) across operating, private-equity, and CFO roles (contractor ground-truth cohort), extended with healthcare practice observations"
  ],
  "last_updated": "2026-Q3",
  "metrics": [
    {
      "key": "days_in_net_a_r",
      "label": "Days in Net A/R",
      "unit": "days",
      "lower_is_better": true,
      "percentiles": {
        "p10": 55,
        "p25": 50,
        "median": 40,
        "p75": 32,
        "p90": 28
      },
      "sample": "HFMA MAP Award + MGMA-style targets",
      "source": "HFMA MAP 2024 Statistical Appendix"
    },
    {
      "key": "pos_cash_collection_of_patient_liability",
      "label": "POS Cash Collection (% of patient liability)",
      "unit": "%",
      "lower_is_better": false,
      "percentiles": {
        "p10": 22.8,
        "p25": 27,
        "median": 35.4,
        "p75": 41.7,
        "p90": 49.2
      },
      "sample": "HFMA MAP Award winners (n=14, 2024)",
      "source": "HFMA MAP 2024 Statistical Appendix"
    },
    {
      "key": "total_medical_revenue_per_physician_fte",
      "label": "Total Medical Revenue per Physician FTE",
      "unit": "K",
      "lower_is_better": false,
      "categories": [
        {
          "name": "Primary Care (all)",
          "value": 668
        },
        {
          "name": "Primary Care (top)",
          "value": 770
        },
        {
          "name": "Surgical (all)",
          "value": 648
        },
        {
          "name": "Surgical (top)",
          "value": 777
        },
        {
          "name": "Multispecialty (top)",
          "value": 879
        }
      ],
      "sample": "MGMA 2023 DataDive, Better Performers vs. all",
      "source": "MGMA Better Performers Report 2023"
    },
    {
      "key": "primary_care_overhead_ratio",
      "label": "Primary Care Overhead Ratio",
      "unit": "%",
      "lower_is_better": true,
      "percentiles": {
        "p90": 50,
        "median": 60,
        "p10": 67
      },
      "sample": "Industry literature; AMA PPI 2024 (PE = 51.1% of cost)",
      "source": "AMA Physician Practice Index 2024 + industry benchmarks"
    },
    {
      "key": "claim_denial_rate_of_claims",
      "label": "Claim Denial Rate (% of claims)",
      "unit": "%",
      "lower_is_better": true,
      "percentiles": {
        "p90": 4
      },
      "sample": "Optum 2024 Denials Index + KFF 2024 ACA analysis",
      "source": "Optum 2024 Denials Index, KFF 2024 ACA Marketplace Analysis"
    },
    {
      "key": "patient_acquisition_cost_by_specialty",
      "label": "Patient Acquisition Cost by Specialty",
      "unit": "value",
      "lower_is_better": false,
      "categories": [
        {
          "name": "Pediatrics",
          "value": 155
        },
        {
          "name": "Family Practice",
          "value": 277
        },
        {
          "name": "Dentistry",
          "value": 374
        },
        {
          "name": "Dermatology",
          "value": 441
        },
        {
          "name": "Cosmetic",
          "value": 610
        }
      ],
      "sample": "Marketing agency database (First Page Sage 2026)",
      "source": "First Page Sage Patient Acquisition Cost Report 2026"
    }
  ],
  "benchmark_table": [
    {
      "metric": "Dental Net Margin",
      "bottom_quartile": "< 20%",
      "median": "25-30% (before owner comp)",
      "top_quartile": "30-40%",
      "note": "Definition matters: ADA Health Policy Institute Survey of Dental Practice 2024 shows median practice net income around 22% of gross billings BEFORE owner compensation, dropping to roughly 13% after a market-rate owner salary. The 25-30% band is a pre-owner-comp figure."
    },
    {
      "metric": "Primary Care Net Margin",
      "bottom_quartile": "< 8%",
      "median": "12-15%",
      "top_quartile": "> 18%",
      "note": "Directional range; overhead discipline drives the gap. Note: many employed-physician models run a subsidy per provider (see below)."
    },
    {
      "metric": "Specialty Clinic Operating Margin",
      "bottom_quartile": "< 15%",
      "median": "18-24%",
      "top_quartile": "> 28%",
      "note": "This band tracks operating margin, not net. MGMA/analyst benchmarks put specialty operating margin at 18-30%; procedure-heavy specialty NET runs higher (25-40%). Procedure-mix dependent."
    },
    {
      "metric": "Net Collection Rate",
      "bottom_quartile": "< 95%",
      "median": "~96%",
      "top_quartile": "99%+",
      "note": "MGMA/HFMA: payments / (charges minus contractual adjustments); below 95% signals a real problem"
    },
    {
      "metric": "Clean Claim Rate (first-pass)",
      "bottom_quartile": "< 90%",
      "median": "~95%",
      "top_quartile": "98%+",
      "note": "HFMA MAP Keys best practice 95%+"
    },
    {
      "metric": "Days in A/R",
      "bottom_quartile": "> 50 days",
      "median": "< 40 days",
      "top_quartile": "< 30 days",
      "note": "MGMA target; HFMA MAP winners 30-45 days"
    },
    {
      "metric": "Cost to Collect",
      "bottom_quartile": "> 4%",
      "median": "2-4%",
      "top_quartile": "< 2%",
      "note": "HFMA MAP Keys, % of net patient revenue"
    },
    {
      "metric": "Subsidy per Employed Physician",
      "bottom_quartile": "> $300K",
      "median": "~$307K",
      "top_quartile": "profitable",
      "note": "Kaufman Hall Physician Flash Report Q4 2024, investment/subsidy per physician FTE"
    },
    {
      "metric": "Patient Collection Rate",
      "bottom_quartile": "< 34%",
      "median": "40-48%",
      "top_quartile": "> 60%",
      "note": "At time of service vs. billing after"
    },
    {
      "metric": "Bad Debt % of Charges",
      "bottom_quartile": "> 2.2%",
      "median": "1.5%",
      "top_quartile": "< 0.6%",
      "note": "HFMA MAP Award winners 2024"
    },
    {
      "metric": "A/R Over 90 Days (% of total)",
      "bottom_quartile": "> 38%",
      "median": "30%",
      "top_quartile": "< 22%",
      "note": "HFMA MAP Award winners 2024"
    },
    {
      "metric": "Cost per Claim Processed",
      "bottom_quartile": "> $12",
      "median": "$8-$10",
      "top_quartile": "< $6",
      "note": "Directionally consistent with the CAQH Index (manual claim-submission cost per transaction $7.19 in 2023, rising to $8.03 in 2025; electronic $2.65-$3.45). Fully-loaded per-claim cost including rework runs higher."
    },
    {
      "metric": "No-Show Rate",
      "bottom_quartile": "> 10%",
      "median": "~7%",
      "top_quartile": "< 5%",
      "note": "MGMA Stat 2023: 6.81% single-specialty avg"
    },
    {
      "metric": "Staff Cost % of Revenue",
      "bottom_quartile": "> 35%",
      "median": "28-32%",
      "top_quartile": "< 25%",
      "note": "Directional; non-provider staff (admin + billing), Level founding-team observation"
    },
    {
      "metric": "Technology Spend % of Revenue",
      "bottom_quartile": "> 5%",
      "median": "3-4%",
      "top_quartile": "< 2.5%",
      "note": "Directional; EMR, PM, billing, telehealth, Level founding-team observation"
    }
  ]
}