VSP Board Director Responds to Open Forum on Healthcare Reform
June 08, 2012
Dr. Mannen calls on the American Optometric Association to address
the access issues associated with healthcare reform
Rancho Cordova, CA – VSP Global recently hosted an open forum on healthcare reform and invited the American Optometric Association (AOA) to participate. Today, Dan Mannen, OD, FAAO, VSP Global Board of Directors, issued a response to the event and communications surrounding it. Dr. Mannen calls on the AOA to address the access issues with healthcare reform.
“If we apply basic business principles, we would never abandon a successful approach for a new direction, without making certain it will work,” said Dr. Mannen. “We cannot put our faith in untested assumptions regarding the unknown, without incurring needless risk.”
Dr. Mannen cited three important points that continue to be overlooked in the ongoing discussion:
- Stand-alone vision plans cannot directly participate in the insurance Exchanges. The only way stand-alone plans can provide care is by partnering with health plans, but there is little opportunity for them to do so, as that pie has already been carved up. Health plan owned vision plans – like Spectera and Davis – are able to participate directly. These plans are generally lower reimbursing plans which marginalize materials.
- The Harkin Amendment does not eliminate the possibility of discrimination against optometrists. The statute is not an “any willing provider” law, which means that some doctors may not be able to participate. Dr. Mannen asks that everyone read the amendment and draw their own conclusion regarding the level of protection it provides:
A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.
Another allied health association, the American Chiropractors Association (ACA)
, stated the Harkin amendment “falls well short of being fully protective of the chiropractic profession’s interests and needs significant improvement before it can be judged satisfactory.”
- The scope of the essential pediatric vision benefit has yet to be defined. Both VSP and the AOA are lobbying for a comprehensive eye exam while health plans are advocating for a vision screening. Who will provide the service is also undecided, meaning optometry’s role is yet to be defined.
“We must protect our current access to patients while we fight to gain medical integration,” Dr. Mannen concludes. “We must not let untested assumptions cloud our business acumen and impair our efforts for optometry to strengthen its rightful place in healthcare.”
To hear Dr. Mannen’s remarks at the healthcare reform open forum, click here
About VSP Global
VSP Global® includes VSP Vision Care, the largest not-for-profit vision benefits and services company in the United States with 57 million members; Marchon® Eyewear Inc., one of the world’s largest manufacturers, designers and distributors of quality fashion and technologically-advanced eyewear and sunwear; Eyefinity® which offers innovative solutions and the premier management software and technology to improve overall practice management and patient experience; VSP Optics Group, industry leaders in new technologies, production processes, service and logistics.
To date, through VSP community outreach programs such as VSP Mobile Eyes® and Sight for Students®, and through relationships including those with the American Red Cross and Prevent Blindness America, VSP has invested more than $145 million in free eyecare and eyewear for nearly 760,000 adults and children in need throughout the United States.