The Optometry Owner’s Guide to Financial Forecasting
Many independent optometrists enter practice ownership through clinical excellence, not business training. The result? Incredible patient care, but poor visibility into financial performance and future planning.
Most ODs know how much they collected last month. But ask these questions:
What will you collect next quarter?
Can you afford to hire another tech by summer?
What if a major vision plan reduced reimbursements next year?
If you cannot answer with confidence, you're not alone.
Forecasting is not about being perfect. It's about creating a clear picture of what’s coming. It is how smart practices avoid unnecessary risk and build models that support intentional growth.
This guide breaks down the process of building and using a forecast in your optometry business, even if you have zero finance background.
Part 1: What Is Financial Forecasting and Why It Matters
Financial forecasting uses current and historical data to estimate your future revenue, expenses, and cash flow.
It is not:
Guesswork
A basic "last year plus 10 percent" calculation
Something only your accountant understands
It is a real-time tool that helps you:
Understand cash flow
Plan for investments or hires
Prepare for low seasons
Make confident, proactive decisions
Practices without forecasts operate in reaction mode. Those with forecasts operate with clarity.
Part 2: What Forecasting Does for Your Practice
1. Supports Confident Decisions
Forecasting gives you a solid financial foundation to support decisions about staffing, expansion, or equipment purchases.
2. Clarifies Your Hiring Plan
If you are considering hiring a new tech or OD, a forecast shows exactly when and how you can afford it.
3. Unlocks Strategic Growth
Expansion requires cash and certainty. Forecasts help you evaluate when to grow and when to pause.
4. Creates Financial Protection
Forecasting helps you plan for slow periods, seasonal dips, or unexpected expenses so they do not hurt your operations.
5. Adds Value to Your Practice
A documented forecast demonstrates to buyers, lenders, or partners that your practice is financially sound and well-managed.
Part 3: What to Include in Your Forecast
A useful forecast includes more than just gross revenue. It should also track:
Revenue by category (exams, optical, testing, subscriptions)
Fixed expenses (rent, payroll, software)
Variable expenses (supplies, marketing, CE)
Cost of goods sold
Recurring revenue streams
Net income
Cash reserves
Bonus metrics like patient volume, capture rate, and per-patient revenue make your forecast even more actionable.
Part 4: How to Build a 12-Month Forecast in 5 Steps
Step 1: Review Historical Data
Look at the last 12 to 24 months. Pull monthly revenue, expenses, and patient counts. Identify seasonal dips or patterns.
Step 2: Build a Monthly Template
Use a spreadsheet with months across the top. Include income categories, expense categories, and a row for profit.
Step 3: Layer In Real Assumptions
If you plan to:
Launch a membership plan
Buy equipment
Increase marketing spend
Hire a staff member
...estimate the cost and timing and enter it into the appropriate month.
Step 4: Create Multiple Scenarios
Forecast three scenarios:
Baseline
Growth
Worst-case
This gives you clarity under different conditions.
Step 5: Review and Update Regularly
Check your forecast monthly. Adjust based on performance. Rebuild fully each quarter if your business is rapidly changing.
Part 5: How Recurring Revenue Improves Forecast Accuracy
Forecasting gets easier when more of your revenue is predictable.
Recurring income, like a membership plan, brings consistent monthly cash flow regardless of patient volume.
Example:
250 patients paying $20 per month equals $5,000 in recurring revenue. That income is reliable even if the office is closed for a few days.
Predictable revenue helps you:
Budget payroll
Manage growth
Reduce risk
Build cash reserves
Recurring models turn forecasting into planning, not guessing.
Part 6: Financial KPIs to Watch
As your forecasting becomes more advanced, track key performance indicators:
Revenue per exam
Net profit margin
Cost of goods sold percentage
Payroll as a percentage of revenue
Optical capture rate
Subscription revenue as a percentage of total income
Number of months of cash reserve
These KPIs help you evaluate if your forecast is healthy and sustainable.
Part 7: Common Mistakes to Avoid
Mistake 1: Ignoring seasonal trends
Do not model every month as identical. Use past years to identify and plan for slow periods.
Mistake 2: Forgetting about collections timing
Billed revenue is not the same as collected revenue. Always model based on what actually hits your account.
Mistake 3: Leaving out your own compensation
Include a line for owner pay separate from business profit so you know your true margins.
Mistake 4: Not forecasting one-time expenses
Equipment purchases, team events, or marketing campaigns should be included in the forecast even if they are irregular.
Mistake 5: Never revisiting the forecast
Update your forecast at least monthly. A stale forecast is just another spreadsheet.
Part 8: Using Forecasts for Growth and Expansion
Once your forecast is functional, you can use it to evaluate:
Hiring an associate OD
Expanding exam lanes
Launching a new specialty service
Opening a second location
Applying for financing
Phasing out low-margin insurance plans
You will be able to model the revenue increase, expense change, and net outcome in advance.
Forecasting puts your practice growth under your control.
Conclusion: Forecasting Is a Leadership Tool, Not a Math Exercise
Owning an optometry practice means leading it — not just working in it.
Forecasting gives you the financial lens to make strategic decisions, guide your team, and build a business with purpose. It’s how you stop running month to month and start building something sustainable.
You do not need to be a finance expert. You just need a process and a plan.
Start simple. Stay consistent. And treat your forecast like the business blueprint it is.
DirectOD Vision Membership Plans are NOT insurance. Members pay a monthly or annual fee directly to participating eye care providers in exchange for access to discounted services, benefits, and product savings as outlined in the provider’s custom membership plan. Members are responsible for paying their provider directly for any services or products received beyond the plan’s benefits. Plan features, pricing, and savings may vary by provider and location — please refer to your provider’s specific plan terms for full details. Vision membership plans offered through DirectOD do not qualify as insurance under the Affordable Care Act and do not satisfy minimum essential coverage requirements. DirectOD is not an insurance company, and does not pay or reimburse providers for services rendered. DirectOD exclusively supports eye care and does not operate in any other medical field or acknowledge outside industry technologies attempting to operate in the eye care industry . For questions regarding your plan, please contact your participating provider or reach out to us at admin@directod.com.
The Optometry Owner’s Guide to Financial Forecasting
Let’s clear something up:
Private practice optometry is not dying.
What’s dying is the belief that great clinical care alone is enough to build a sustainable business.
The people saying “private practice is dead” are often the ones clinging to outdated systems, refusing to change, and ignoring the reality that healthcare is now a business, and that running one takes more than a license and a lane.
This isn’t a hit piece. It’s a reality check.
Because independent optometry isn’t collapsing.
It’s evolving. And if you’re not evolving with it, it might feel like it’s dying.
Why Private Practices Are Struggling
It’s easy to point fingers at outside threats:
Online retailers
VSP and Eyemed
Corporate chains
LensCrafters and Costco
Amazon’s push into healthcare
But here’s the uncomfortable truth:
Most struggling private practices are failing because of decisions made inside the building.
Here’s what we’re really dealing with:
A business education gap
Over-reliance on vision plans that pay less every year
Undercharging and over-delivering
No systems for retention, referrals, or upsells
Lack of recurring revenue
Burned out owners doing everything manually
Staff with no training in communication, conversion, or service
This isn’t a competition problem. It’s a business model problem.
Why Clinical Excellence Isn’t Enough Anymore
You can be the best diagnostician in the state.
You can detect subtle pathology before it’s visible on OCT.
You can have the latest equipment and be the friendliest doctor in town.
But if your pricing is unclear, your team is untrained, your office is disorganized, and your cash flow is built around slow-paying insurance claims, your practice will struggle.
In today’s landscape, patients expect more:
Clear pricing
Fast scheduling
Easy communication
Subscription-style options
Service that feels like retail, not red tape
The modern patient doesn’t care that you’ve been in practice 20 years. They care how your office makes them feel and how hard it is to do business with you.
The Illusion of “Busy” Is Killing Private Practice
Many ODs think they’re doing well because they’re booked out two weeks.
But busy isn’t the goal. Profitable and scalable is.
You might be:
Seeing 20 or more patients a day but still can’t afford to hire help
Selling multiple pairs of glasses and still losing money to labs
Participating in every plan to keep the schedule full while losing money on each visit
Giving up evenings, weekends, and energy for a practice that doesn’t pay you like an owner
That’s not private practice thriving. That’s private practice surviving.
Why Private Practice Isn’t Dying
Independent optometry is doing just fine for those who:
Understand marketing, pricing, and retention
Build systems that reduce dependence on the owner
Know how to create recurring revenue from loyal patients
Train their staff to convert and educate
Create an experience that patients remember, not tolerate
There are practices across the country generating:
30,000-150,00+ dollars or more in recurring annual revenue from in-office plans
600 dollars or more in average patient value through bundled services and education
60 percent or higher optical capture rates with no pressure selling
90 percent or higher retention rates through simplified patient journeys
These are not lucky practices. They are intentional practices run by optometrists who became entrepreneurs.
What’s Actually Killing Practices and How to Stop It
Insurance Dependency
Vision plans aren’t evil. But building your practice around them is a mistake.
Low reimbursements, delayed payments, and patient confusion are crushing your margins.
Solution: Offer your own in-office vision membership plan and keep revenue in-house.Weak Front Desk Conversion
If your staff can’t answer the phone, guide the call, and close the appointment, you’re losing patients every day.
Solution: Train your front desk like a revenue center. Use scripts, tracking, and objection handling.No Recurring Revenue
Most ODs earn only when they show up. If your income stops when you take a vacation, you don’t own a business. You own a job.
Solution: Create subscription-based offerings like membership plans, contact lens programs, or wellness bundles.Low Per-Patient Value
You might see 2,000+ patients a year. But if each one only brings in 100 dollars of profit, it’s not enough.
Solution: Package services, educate patients, and improve optical capture with better presentation.Lack of Leadership
If your team is disengaged, your systems are inconsistent, and your practice runs on chaos, you’re not leading.
Solution: Step into the CEO role. Stop being the only technician in the business.
Private Practice Is a Business. Start Treating It Like One.
If you want to stay independent, you need to think like an owner, not just a doctor.
That means:
Understanding your margins
Knowing your per-patient revenue
Investing in training, not just equipment
Offering modern payment options
Creating a brand that patients remember
Leading your team toward clear business goals
This isn’t about selling out or going corporate. It’s about owning your future instead of outsourcing it.
The Winners Are Already Making the Shift
Across the country, practices are breaking free from the old way of doing things:
They’re dropping low-paying plans
Launching vision membership plans that patients love
Streamlining the patient journey
Building scalable, systemized businesses
Working less but earning more
These aren’t unicorns. They’re private practices that stopped waiting for things to change and made the change themselves.
Want to Build a Private Practice That Actually Grows?
DirectOD helps independent optometrists create recurring revenue, streamline their business, and finally get paid for the care they deliver.
We are not just a software platform. We are your partner in transforming how your practice earns.
With DirectOD, you get:
A fully built, legally compliant in-office vision membership plan
Custom pricing, branding, and benefit structures
Automated patient billing and plan management
Marketing assets, front desk scripts, and training guides
Support from a team that has built practices just like yours
If you're tired of working harder and earning less, there’s a better way.
We’ll show you how to build a model that patients want and your practice needs.
Lexington, KY
40509 US
DirectOD Vision Membership Plans are NOT insurance. Members pay a monthly or annual fee directly to participating eye care providers in exchange for access to discounted services, benefits, and product savings as outlined in the provider’s custom membership plan. Members are responsible for paying their provider directly for any services or products received beyond the plan’s benefits. Plan features, pricing, and savings may vary by provider and location — please refer to your provider’s specific plan terms for full details. Vision membership plans offered through DirectOD do not qualify as insurance under the Affordable Care Act and do not satisfy minimum essential coverage requirements. DirectOD is not an insurance company, and does not pay or reimburse providers for services rendered. DirectOD exclusively supports eye care and does not operate in any other medical field or acknowledge outside industry technologies attempting to operate in the eye care industry . For questions regarding your plan, please contact your participating provider or reach out to us at admin@directod.com.