A Vision For Vision Care
Has this ever happened to you? A family that has been patients of mine for many years—mom, dad, and the three kids—recently came in for their annual eye examinations. We had a very pleasant conversation about a recent vacation, how the kids were doing in school, and a recent hunting adventure. It all went great! Then they turned to me on the way to the dispensary and said, "I'm sorry to tell you but this will be our last time coming to your office. We will no longer have vision insurance, but I do want to thank you for all your help over these many years."
Vision plans are a primary source of patients for many independent practices. Recent numbers from the Vision Council indicate that 53% of Americans now have vision benefits1. The number of people with vision coverage has actually increased by 18% since 20112. Despite having a critical role in creating patient care opportunities, the vision care access channel has recently come under scrutiny by some in our own profession. Both state and federal legislation has been put forth and passed in over 20 states under the banner of vision plan abuses. While I acknowledge that it is crucial to conduct routine reviews of vision plan programs and policies, legislative remedies always have the potential for unintended consequences.
Independent optometry enjoys a unique competitive advantage with two synergistic but distinct access channels by which patients approach our practices: the vision care channel and the medical or health plan channel. In many independent practices, a majority of patients are initially seen as vision care patients. Because patients place great value on the vision plan benefit, both access and utilization are very high in managed vision care. In fact, vision coverage raises awareness about eye care and results in increased access and participation for both the patient and the entire family.
By contrast, the medical or health plan channel continues to be a work in progress. Some optometrists are still excluded from medical panels, significantly limiting patient access. A prime example would be many California doctors who continue to endure limited medical panel opportunity. In addition, optometrists are often underutilized even when they are included on medical panels. I have been fortunate to have been a medical panel provider for nearly all health plans in my area for many years. I also live in a small town and have a relationship with most of the local doctors and yet, receive only a trickle of direct medical referrals. It continues to be a challenge to overcome longstanding referral patterns and relationships. However, as a medical panel provider, I have been able to build a significant medical practice by transitioning my own vision care patients to medical patients as my patient base has matured.
Vision benefits rank as one of the most highly valued employee health benefits. In fact, patients love vision care. Patients understand the importance of eye care and recognize value in both the service and material components of the vision benefit. Improved integration and coordination of vision care benefits with medical care would further increase their value by addressing economic issues for both patients and doctors. Many years of targeted patient education have demonstrated the importance of both health and performance and have made eye care an integral component of wellness. Participants continue to sign up in record numbers thus availing themselves of important and cost effective eye care services.
When patients have a vision care benefit, they come in for eye care services more frequently: 19 months with, 30 months without, and purchase eyewear more often - 65% with, 35% without3. They exhibit confidence in their plan and see real value in their benefit. Contrast that with a patient without vision coverage who is flooded with competing offers, often of lower quality and specificity. The compelling value of the vision benefit is definitely a difference maker when patients make choices for their eye care. Patient satisfaction rates with vision benefit plans are typically high. According to the most recent National Vision Plan Satisfaction Survey, nearly 70% of employees with an employer based vision plan indicated they would highly recommend their vision plan4. What's good for the patient is also good for the practice.
It is imperative that optometry continues to actively pursue full access, utilization, and parity within the medical channel. Optometry has an impressive track record in achieving excellent outcomes in medical management. However, as we continue to pursue medical inclusion, it is clear that further progress will take time. I think this is particularly true given the current medical landscape of escalating costs, increasingly restrictive panels, and high deductibles. That is why it is so important to preserve and enhance both complementary access channels. The sum of the two is greater than the individual parts. Vision care facilitates medical care opportunities and medical care leads to vision care opportunities.
In summary, the vision care access channel and the medical or health plan access channels are both significant for independent optometry. In this evolving and challenging marketplace, complementary access channels give patients choices and give doctors options. Multiple access channels should be seen as a competitive advantage for independent practices. Therefore, it is vitally important that caution is exercised when advocating actions, including legislative actions, which might ultimately impact the value proposition for the participant and lead to a reduced flow of patients through the vision care channel.
How should you respond to this information?
- Ask yourself: Where do my patients come from?
- Remember that your patients place great value on their vision care benefit.
- Understand the importance of the value proposition which compels people to enroll and to visit their doctor.
- And discuss objectively with your colleagues, the importance of a steady flow of vision plan patients to your practice.
As a member of the VSP Global Board of Directors, I am passionate about preserving and enhancing independent practice and about creating patient care opportunities. But my passion actually runs much deeper. I am so excited that both of my kids have chosen optometry as their profession and I am very positive about their future. We have so much to offer, we simply need a game plan. In my view, the blueprint for optometry is to remember our roots and embrace the fact that patients love vision care as we continue to pursue full access, utilization, and parity within medicine. Independent optometry is blessed with multiple complementary access channels and is positioned very favorably for continued success.
Daniel L. Mannen. O.D., F.A.A.O., Chairman, VSP Global Board of Directors
Dr. Daniel L. Mannen has spent 31 years in private independent optometric practice in Oregon. He is past president of the Oregon Optometric Physician's Association. Dr. Mannen is currently in his second term as Chairman of the Board for VSP Global. He is the primary author of the As Eye See It blog and has written and spoken extensively on optometric practice management and policy issues.
1, 2, 3 focalCenter, Advantages of Vision Benefits for Patients and Providers, June 2016
4 BlueOcean, National Vision Plan Member Research, July 2014.