testing 123
By the way---Race, are you saying that you don't speak for VSP? You're just a dedicated amateur, like Emma Peel? Well Faith and Begorrah, I believe anything you say.
testing 123
By the way---Race, are you saying that you don't speak for VSP? You're just a dedicated amateur, like Emma Peel? Well Faith and Begorrah, I believe anything you say.
I'm not speaking for anyone but me. I'm just sharing my opinions in a series of heated debates on topics that center around an obviously touchy subject around here. Shame me for it all you will. Show me just about any topic other than VSP discussed here and you'll a number of people willing to chime in with their facts and details. Chests pound all day long when it comes to technical talk and brothers in arms come out to support the "little guy" companies all day long. However when a subject of VSP comes up around here, it's just a bunch of the same old people in agreement around opinions that have very little in the way of facts to back them up and get upset when I question their stance.Originally Posted by finefocus
I'm sorry if these discussions are so disliked. Again, perhaps many of you would prefer to just discuss myth and appear as a unified group of bobble heads when it comes to discussing managed care from an opposing view point. Fine by me, I'll leave if you all want me to . Collective call I suppose. Flood my PM box with notes, comments and suggestions or hate mail if you feel so inclined.
Last edited by racethe1320; 04-22-2012 at 07:45 AM.
It's not a personal attack on you...you would make an excellent congressman. You answer questions with questions, without really answering the original question.
Simply stated: Besides receiving reimbursement for services rendered as a provider, are you paid by VSP for services outside of being a run of the mill provider?
I think we know you want to provide "alternate views", however, just like reviewing research articles, one needs to look to see who sponsors the writer.
I appreciate the opposing view that you offer and I have changed my thinking on how our office attacks VSP and other insurances based on your input. By becoming a bit more open minded, I realize that I need to take a harder look at how I do business and how I can better profit by accepting these plans.
Your opinion, experience, and viewpoint may not be popular, but I for one am glad that you contribute. Thank you!
Quick Question - Can we clarify pros and cons and define a business model we’d like to see? This is my interpretation of what I have seen so far. What is stated incorrectly and what is missing?
Pro: Doctors can become internet retail providers.
Con: Doctor’s are putting their patients at risk before the online market has matured to include quality control protocols that are good for the patient. According to a recent study, almost half of the eyewear sold online does not meet z80 compliance standards. When doctors promote online retail, we know patients will comparison shop for lowest price, and many will purchase lenses with poor safety profile and poor optics.
The VSP business model has removed the step of verification by the ECP.
Pro/Con: The VSP business model includes VSP Provider skin in the game. If the ECP purchases an online internet retail avenue for sales, the ECP will promote patients buying eye wear online.
Pro: Doctors gain some opportunity to capture patients, within their practice, when/if those patients buy online.
Con: Once patients are advised to shop online, by the trusted doctor and staff, patients are more likely to leave the Brick and Mortar office and buy online. If doctor treats prescription eye glasses like a commodity, patients will do the same.
Pro: Doctors gain some opportunity to capture patients, from other VSP providers, when their patients elect to buy online. There is an advantage to being an early adapter, while other VSP providers have not yet enrolled. (This is part of the business model I did not understand, and still I am not clear about it.)
Pro: VSP offers product mix of Single Vision packages and Marchon and Altair frames. It is relatively easy for ECP to set their own online retail fees for these products. Offices differ from one another by selecting frames they will sell, from the products allowed.
Con: VSP is making prescription eye wear a commodity. Patients can shop a lens package and frame, and the only difference is price.
Con: Independent providers give up some of their independence, as business owners, to offer a different frame selection and obtain volume purchasing savings on frames and lenses. In addition, the cost of business is increasing. ECP pays for the website and pays higher wholesale for products than if purchasing clinically equivalent products with the ability to comparison shop wholesale suppliers.
Pro/Con: VSP is moving into the Private Pay arena, and using their provider network to do it. For the provider, there is some benefit to being an early adapter, a competitive advantage against other VSP providers. There are plenty of disadvantages. This is a good time for a private company or independent lab to offer something better. We are lacking competition in the marketplace, so that ECPs - who are new to internet retail - have some good choices.
A Better Business Model: (This is a wish list, for a great alternative)
- Provide the website for free, instead of charging the provider a fee
- Allow the provider to customize the look of their site, as a way to differentiate businesses
- The website should link from the ECPs existing website
- Disclosure of wholesale lens and frame fees, prior to engaging in contract
- Allow the ECP to select the lab provider that will do the lens fabrication
- Some sort of co-management for fitting, dispensing, and warranties
- Connect the patient to the ECP during ordering/measuring/fitting process, so that patients purchase products best for them.
- Connect the patient to the ECP for prescription verification and proper frame adjustment and lens alignment at dispense.
- Support the trust relationship between the ECP and their patient base. Do not entice or encourage patients to leave their doctor.
- Do not promote the notion that prescription eyewear is a commodity, easily comparison shopped online.
- Products must be current and product offerings consistently updated, so the patient never purchases a frame on backorder
- Ideally, ECPs would have product choice, so that purchases do not support companies they believe are gaining market share at the detriment of the independent professionals.
Renee Kathleen Jacobs O.D., M.A.
Director Practice Management Depot
www.PracticeManagementDepot.com
I have not seen a conversation addressing the hurdle that presently there is a difference between online retailers and B&M locations. B&M locations have higher overhead costs, like rent, and we include services bundled with our frame and lens product fees. For this reason, B&M fees are likely to be higher for identical product offerings - when ECPs set their online fees. Do ECPs want to pay to be in the online market, and recommend online shopping to their patients, if ECPs are not competitive in that marketplace. Success is far more complicated than just having an online presence.
Renee Kathleen Jacobs O.D., M.A.
Director Practice Management Depot
www.PracticeManagementDepot.com
Renee, this is the best thought-out post (not just VSP's new involvement) here on OB on the subject; Should we as a profession embrace, condone and recommend online as a ethical delivery system for a non-commodity medical device.
Congressman counterparts would hate me because I wouldn't fold like so many of ours do. I won't take your comments as personal as perhaps I did originally. Thanks for openly sharing. I'll try and do better to answer your questions in the future but just know that my approach is the way it is as I can either answer the questions posed directly but run a strong risk of coming across as a know it all or preaching. My style is rather to ask others questions that will eventually cause them to answer the original one they posed to me all on their own. Make sense? In short (if there is such a thing with me) If I can guide you to the facts and understanding that final point will have much stronger credibility than my just firing off my opinions.
No I am not paid by VSP for anything outside my services as a panel provider. I do have an interest in being a state representative for them, but that's a process and one that might not happen, but is something I won't stop pursing. My main cause here is just to share what I know based on what I have learned and will continue to learn over the years. I have business background and a son that works in managed care but not for VSP, so I do have a pretty good understanding of that side of the business.Simply stated: Besides receiving reimbursement for services rendered as a provider, are you paid by VSP for services outside of being a run of the mill provider?
I understand your point. Credibility and background. I keep a low profile outside a handful here that have PM'd me regularly and honestly you and I and others will come to know one another better. Until then I hope to build my credibility by showing facts and talking through things that everyone can then go research to see is not BS or just my opinion.I think we know you want to provide "alternate views", however, just like reviewing research articles, one needs to look to see who sponsors the writer.
Yes, that would make for a great post. Here if I slant off and talk VSP it's because I'm also trying to address their move to online via Eyeconic.
Docs going online is nothing new. Many already have some type of online site that includes retail. Even if it's just plano eyewear sites exist. The key understanding here is what's driving this? Answer is the markeplace aka the consumer. We have two choices, fight it or embrace and attack it ourselves and take control of our own destiny. That's all VSP is doing with the intent to survive themselves and do that through the survival of their key retail component in this dog fight....their panel providers which are in reality their retail front.Pro: Doctors can become internet retail providers.
Con: Doctor’s are putting their patients at risk before the online market has matured to include quality control protocols that are good for the patient. According to a recent study, almost half of the eyewear sold online does not meet z80 compliance standards. When doctors promote online retail, we know patients will comparison shop for lowest price, and many will purchase lenses with poor safety profile and poor optics.
I still challenge you that online isn't all about price. Patients are well aware that quality differences exist and if they are shopping online, those shoppers are very likely already savvy enough to avoid the poor service providers. Are some going to get poor quality products, yes. However, should our concern as independents be trying to fix the business model or insure what we are delivering is quality product? I don't think we as a group have the ability to organize effectively to change the marketplace the is already in motion and buying through those we compete with already. Your opinion may vary. VSP is trying to change the model but they are are doing it first through Panel Providers.
How so? All their Eyeconic site is doing is providing you as a panel provider a portal to complete a transaction. The Rx's delivered through their system are absolutely verified. No Rx, no order, unless it's a plano. Even then, they ask the customer to list their preferred ECP.The VSP business model has removed the step of verification by the ECP.
Yes, there's skin in the game for both the ECP and VSP. Don't forget, this move for them isn't free and easy either. In terms of the ECP promoting patients buy online, I personally don't see setting up a site like this as promoting it. What's the alternative if you don't embrace or talk about online to a patient? Chances are they won't see you as "in the game" an will likely go elsewhere. They already are folks...like it or not, the online e-tailers are making money.Pro/Con: The VSP business model includes VSP Provider skin in the game. If the ECP purchases an online internet retail avenue for sales, the ECP will promote patients buying eye wear online.
Bingo.Pro: Doctors gain some opportunity to capture patients, within their practice, when/if those patients buy online.
Perhaps, but patients are going online already. In droves and without anyone here talking about it. Anytime a patient leaves your office with an Rx, don't worry so much about them going online, because they could be going down the street. Worry about how to get them to bring that Rx back to you in some way. If they've left, they've left. That decision is happening like it or not. They aren't going to be more likely to go online simply because you talked about it. Look at sites like Best Buy or Apple. I can buy a TV or a Camera or an iPhone or iPod online or in the store. Sure, online sales are going up, but Apple just opened their new Flagship Store in Grand Central Station and Best Buy continues to open new doors each month too. You have to know how to succeed at both. Embracing and controlling it is the key, not hiding from it or not promoting it.Con: Once patients are advised to shop online, by the trusted doctor and staff, patients are more likely to leave the Brick and Mortar office and buy online. If doctor treats prescription eye glasses like a commodity, patients will do the same.
Meh....I'm not sure if you're going to gain sales from other ECP's or vise-versa. If the patient is buying an Rx'able product they have to provide the Rx and that doctor is the one who earns the sale. Unless as you stated, their provider opts out. I doubt many will really.Pro: Doctors gain some opportunity to capture patients, from other VSP providers, when their patients elect to buy online. There is an advantage to being an early adapter, while other VSP providers have not yet enrolled. (This is part of the business model I did not understand, and still I am not clear about it.)
Yes.Pro: VSP offers product mix of Single Vision packages and Marchon and Altair frames. It is relatively easy for ECP to set their own online retail fees for these products. Offices differ from one another by selecting frames they will sell, from the products allowed.
I don't see it as VSP influencing Rx's as a commodity. Patients already do to some extent. Often times they take their Rx out of your office because of frame selecton. I know as I have my team call patients that don't fill in my dispensary as part of our follow up and if they buy elsewhere I push to find out why. By far the number one answer is frame selection. I can't carry everything and putting myself in their shoes, I suppose I would walk too. Those looking to shop price online are already going to do that. They don't need you me or VSP to encourage them.Con: VSP is making prescription eye wear a commodity. Patients can shop a lens package and frame, and the only difference is price.
One might argue that point, but again, Vision Benefits make up very little in the way of time that people spend when it comes to making a decision. I think everyone here will agree the vast majority of people out there spend more time deciding on where to go for lunch than they do on their decision as to where to buy glasses.
How so? VSP's model isn't asking that you give up any independence as you can order any of your other products through any other wholesale supplier you wish and support multiple entry points into online shopping.Con: Independent providers give up some of their independence, as business owners, to offer a different frame selection and obtain volume purchasing savings on frames and lenses. In addition, the cost of business is increasing. ECP pays for the website and pays higher wholesale for products than if purchasing clinically equivalent products with the ability to comparison shop wholesale suppliers.
VSP has always been in the private pay arena. Both in their labs and through their ECP's. I sell Marchon frames all day long to EyeMed patients and people who do not have any managed care plan at all. I agree that perhaps a private company or independent lab should consider a similar move, but I'll say it again, they don't because they are looking out for themselves first and foremost. VSP does not.....and yes, I'd be happy to point out details should this debate ensue. Hopefully in another thread :)Pro/Con: VSP is moving into the Private Pay arena, and using their provider network to do it. For the provider, there is some benefit to being an early adapter, a competitive advantage against other VSP providers. There are plenty of disadvantages. This is a good time for a private company or independent lab to offer something better. We are lacking competition in the marketplace, so that ECPs - who are new to internet retail - have some good choices.
A Better Business Model: (This is a wish list, for a great alternative)I'll try and address the above point for point.
- Provide the website for free, instead of charging the provider a fee
- Allow the provider to customize the look of their site, as a way to differentiate businesses
- The website should link from the ECPs existing website
- Disclosure of wholesale lens and frame fees, prior to engaging in contract
- Allow the ECP to select the lab provider that will do the lens fabrication
- Some sort of co-management for fitting, dispensing, and warranties
- Connect the patient to the ECP during ordering/measuring/fitting process, so that patients purchase products best for them.
- Connect the patient to the ECP for prescription verification and proper frame adjustment and lens alignment at dispense.
- Support the trust relationship between the ECP and their patient base. Do not entice or encourage patients to leave their doctor.
- Do not promote the notion that prescription eyewear is a commodity, easily comparison shopped online.
- Products must be current and product offerings consistently updated, so the patient never purchases a frame on backorder
- Ideally, ECPs would have product choice, so that purchases do not support companies they believe are gaining market share at the detriment of the independent professionals.
- Since there's no such thing as a FREE Lunch, how would such an offer be funded? If it was a private or independant company, it's likely going to involve coughing up a percentage of revenue or a fee of some sort.
- There are already sites that offer a provider ways to customize your site. I don't know the details but I do believe VSP's site does as well.
- I do believe there's a link to your site too. I know the point of it is that it will tie into your existing site.
- I also believe VSP's program details the fees and reimbursements to you the ECP.
- In terms of the lab provider, I don't know the details, but my guess is VSP wants to control this as they own the lenses, labs and frames and can insure speedy delivery. It's their program and thus they also want to reap the benefits here too. Nothing wrong with that, they created it not the other labs.
- I do believe they have warranty issues addressed.
- They do connect the ECP and Fitting and Fitting Fees so no patient will get an Rx delivered with no where to go for adjustments and warranty concerns.
- They do verify Rx's.
- They are NOT encouraging patients leave the practice and go online. I've not seen all their communications on this to a patient but that's their message and I do believe they will stay true to that word.
- I don't feel VSP promotes eyewear as a commodity. They are simply responding to the marketplace in a way that will benefit their panel providers in ways that no one else is doing.
- Current and on time delivery is what they are committing to. One can only hope and trust they will deliver. Some here will banter, but I'll just suggest the wasted speculation stop until the darn thing goes live.
- In terms of product choice, I do believe that will open up, but again, this isn't even really a driving force program yet. IN the short term however, again, I can't fault them for supporting only their products. If doing so hurts the ECP, then those ECP's have to understand the choice They are Making may not line up with the direction VSP is going and that's not VSP's fault if their online program doesn't match up.
Wow! I gotta stop as the above is more than I would care to sift through
I'll leave it at this, especially since we have a ton of NY, NJ and East Coast folks here. Look at http://www.bhphotovideo.com/
They are both one of the largest B&M and Online players in their market. They are in an even more competeitve space than us and one in which they are far more players that are online only, yet they are thriving in a difficult economy and and succeed in both formats. Why?
You're right, it's a far more complicated model than we're used to but it can be done.
Race, like Fezz, I thank you for coming here. You state your case very well. I too have had changes on my thoughts on managed eye care. But this particular thread gets to the heart of where we, as a profession should go. Just because there is a sub market, such as e-eyewear, should we embrace it, even thought we know, as professionals, that it is not an ideal way to deliver a custom made device.
Do we do it because *It's out there, and I want my share?* Or do we never condone it..It's a faulty delivery system and not in our patients/clients best interest. As a profession, should we take this stance? "It must be ok to buy my eye glass Rx off the net, because my doc has a link to do it."
Thanks for the kind words and understanding. I hope to adjust my delivery to not appear as harsh at times but again, no ill intent is ever meant.
I think there's a middle ground. I don't think even consumers are ready yet to full accept online eye wear either, but the numbers do show a telling tale that the market is going that route. Not to prepare for it ahead of time would be foolish for us. Thus I don't think we should look to never condone it. Especially since some very large players in the market, even namely just Lux, let alone others, are sure making a push to move online more mainstream.Do we do it because *It's out there, and I want my share?* Or do we never condone it..It's a faulty delivery system and not in our patients/clients best interest. As a profession, should we take this stance? "It must be ok to buy my eye glass Rx off the net, because my doc has a link to do it."
That said, differentiation and yes, protecting market share are key. If we can use programs that benefit us as independents that's good. If that same system differentiates our offering from the likes of the generic retail / etail only sites, then even better.
So now getting back to RKJ's initial post, of all the entry points into online who has the best and most beneficial to helping independents and securing integrity for the product with the patients best interest in mind? Their question was regarding VSP's offering. So how does that then begin to compare to what else is out there?
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