The ROI of OR Demand Forecasting: What to Expect in Year One
By Caleb Lush, Chief Revenue Officer, ORlogic
If you’re a perioperative leader or anesthesia group administrator evaluating an OR demand forecasting platform, you’ve probably been handed a vendor slide deck with a headline ROI claim that feels too good to be true. Something like “10x ROI” or “effectively free.”
I get the skepticism. So, let’s skip the marketing math and talk about what year one looks like — where the savings come from, how fast they show up, and how to pressure-test any ROI case you’re presented.
The Core Problem (And Why It’s Gotten Expensive)
The average anesthesia group or health system OR I’ve spoken with is spending somewhere between $2M and $5M per year on locum services. That number has gone up a lot over the past few years. Workforce shortages, contract inflation, and the fact that most scheduling and staffing decisions aren’t finalized until one or two days out, using scheduling exports, spreadsheets, and institutional memory.
The fundamental issue isn’t that locums are bad. It’s that most organizations are placing locum contracts 90 to 120 days in advance without reliable demand data. So, they overbuy to hedge. And then they’re locked in.
And here’s the part that doesn’t get talked about enough: locum companies don’t love this arrangement either. When you book providers without confidence in your demand, and then things change at the last minute, that creates contractual tension and erodes the morale of the providers you’re relying on. The best locum CRNAs have options. If your organization becomes known for last-minute changes and poor planning, you start losing access to the best talent in the pool. That’s a compounding problem.
Demand forecasting doesn’t eliminate the need for flexible staffing. It eliminates the need to constantly revisit your scheduling across disparate perioperative teams up until the moment the case starts.
Where the Money Actually Comes from in Year One
When I walk through an ROI case with a Director of Anesthesia or VP of Surgical Services, I organize year one value into four buckets:
1. Reduced premium labor spend
This is the big one. If your group is running 20 to 40 locum CRNAs at any given time, even a 5 to 7% reduction in locum utilization moves the needle by hundreds of thousands of dollars. On a $3M locum spend baseline, that’s $150K to $210K in year one savings.
The mechanism is simple: when you can confidently see your procedural demand 15 to 30 days into the future, you right-size your locum commitments instead of over-committing as a safety net. If the locum commitments can’t be canceled, you move them to days where you can predict you’ll be understaffed which preserves the value you’ve already paid for, even if it isn’t the same as a hard reduction in spend.
2. Reduced overtime and callback costs
This one’s harder to track because it lives in payroll rather than vendor invoices, but it’s real. Over and understaffing events are chronic in ORs that run on reactive scheduling. Each callback, each unplanned overtime shift, each day you’re paying a CRNA to sit idle because case volume dropped: that adds up fast. For a hospital in the range of $3M in locum spend, unplanned overtime and callback costs typically run $200K to $400K annually. Don’t get me wrong — you should want to pay some overtime. You just don’t want to overpay. Demand forecasting surfaces misalignments before they become labor events.
3. Time savings for your administrative and clinical staff
This one tends to get undervalued in ROI conversations, but it’s significant. The people running your OR board and managing your schedules are spending enormous amounts of time doing manual coordination work — pulling data from multiple systems, chasing down updates, rebuilding the schedule when something changes. In the implementations I’ve seen, that manual lift can drop by as much as 80% for administrative roles managing scheduling and board running.
That time has real dollar value, but the more important point is what it unlocks. When you reduce the administrative burden on clinical staff who’ve been pulled into scheduling and board management roles, you get them back in the OR doing what they signed up to do. Which brings us to the next point.
4. Case volume optimization
When staffing is consistently right sized and the clinical folks who’ve been reviewing schedules and running the board can get back into the ORs, you can run more cases. You’re not canceling or pushing cases because you don’t have coverage. You’re not carrying excess capacity that sits idle. And you’ve now got experienced clinicians back in rooms contributing to throughput instead of managing spreadsheets. More room coverage, more cases, more revenue — without adding headcount.
What a Realistic Year One ROI Looks Like
Let me give you a grounded scenario. Not a best case. A realistic mid-range case.
Inputs:
• Annual locum/agency CRNA spend: $3M
• Platform investment (annual): $50K
• Conservative labor cost reduction: 5 to 7%
• Estimated overtime and callback spend: $300K (conservative midpoint)
• Assumed overtime reduction: 20 to 30%
Output:
• Locum labor savings: $150K to $210K
• Overtime/callback savings: $60K to $90K
• Combined gross savings: $210K to $300K
• Net benefit after platform cost: $160K to $250K
• Return on platform cost: roughly 4x to 6x in year one (the combined gross savings measured against the $50K platform investment)
One note on method: I’ve deliberately left buckets three and four, administrative time savings and case-volume optimization, out of this model. They’re real, and for many groups they’re the larger long-term prize, but they’re harder to attribute cleanly. I’d rather treat them as upside than bake them into the headline number.
That’s not 10x. But it also means the platform pays for itself multiple times over in the first year, and the ROI improves in year two and three as you have more historical data to work with and more levers to pull.
For groups on the higher end of locum spend — $4M or above — the math gets more aggressive quickly. The platform cost stays roughly fixed while the percentage improvement applies to a larger base.
What Affects Whether You Hit These Numbers
Honest answer: not every implementation produces the same results. Here’s what I’ve seen move the needle in either direction.
Factors that accelerate ROI:
• Willingness to change how contracts are placed (the platform only helps if scheduling decisions change with it)
• It helps to have at least one champion inside anesthesia leadership who owns the output and acts on it
• High current locum dependency (the more you’re spending, the more you save)
• Clean data from your EHR, so the faster the integration, the faster the value
Factors that slow it down:
• Organizational inertia around scheduling workflows
• Anesthesia group and hospital OR operating as separate silos without shared visibility
• Waiting for the other parts of your tech stack to do something they weren’t designed to do
• Renegotiating locum contracts mid-term (there’s often a lag between when you have the data and when you can act on the contracts)
The last point matters more than most vendors will tell you. If you’re locked into locum contracts through Q3, your year one savings may be back-half loaded. That’s not a reason not to move — it’s a reason to start sooner.
How to Pressure-Test Any ROI Case You’re Presented
Before you sign anything, ask these questions:
1. What’s the methodology behind the savings estimate? Is it modeled from your actual historical case volume and locum spend, or is it a generic percentage applied to a benchmark?
2. What does implementation look like, and when does value start? A platform that takes six months to configure gives you six months of zero ROI in year one. Fast integrations — weeks, not months — are a real differentiator.
3. How does the ROI measurement work post-implementation? You should be able to pull a report that shows locum usage before and after, not just take the vendor’s word for it.
The Bottom Line
OR demand forecasting is not a cost. It’s a cost offset. The economics work because the problem it’s solving — premium labor over spend driven by poor demand visibility — is expensive, and the platform investment is a fraction of the labor spend it’s targeting.
For most mid-sized anesthesia groups and health system ORs, a 4x to 6x return in year one is well within reach. The ceiling is higher if your spend is high and your organization moves fast. The floor is still strongly positive for almost any group running meaningful locum volume.
If you’re evaluating this category and want to walk through what the numbers look like for your specific operation, I’m happy to do that. No slide deck required.