OK, the ACA is bullet-proof. And repeal and replace is only an election slogan. Having said that, we are going to have health insurance expense go through the roof. I seriously doubt "stand alone vision care plans" can make it. Free market for optical is coming, people. (Except kids. That's been nationalized.) (And expanded Medicaid patients will be getting their glasses from Medicaid offices.)
I really hope this doesn't degenerate into yet another online political p$ssing match. There are plenty enough places people can go to rant and rave to their heart's content. At OptiBoard, I'd like us to concentrate on things we have in common rather than the things that drive us apart.
OptiBoard Administrator
----
OptiBoard has been proudly serving the Eyecare Community since 1995.
What did I say? This is time to think ahead, no?
I got great budget packages that come with the same service as my ultrapremium lens/frame combos. Anyone can get glasses from me if they want to, I would welcome an influx of new patients (and am willing to advertise like crazy that they can get this level of care and service, if what you say is true)
If my crystal ball works, I think your strategy is superb.
As "stand alone plans" do you mean Eye Med and VSP? I would think they would position themselves as a "better" benefit than anything the ACA offers.
Some of us are very well prepared for private pay only since that's all we've done for a very long time. The demise of VCP's will close many, many offices though. There are so many with;
1. A lousy location
2. A doc with no personality
3. Mediocre staff, at the best.
The ACA doesn't offer vision benefits. The VCPs have to sell themselves to the companies. With health insurance rates skyrocketing, I'm not sure they will be in a buying mood. In fact, it's possible that some employers will just tell the employees to buy their own health insurance on the exchanges. I think the general trend will be to dump health care costs.Originally Posted by Uncle Fester
Massachusetts was one of 14 States that the ruling would not have affected as we have our own exchange. I see more States now adopting our model where the silver and gold plans offer some type of VCP depending on who you sign up with. In that case I can see where VSP would be very concerned and Eye Med not so much.
Would you agree that was EM's hope all along?
I'm interest in the marketing aspect of this thread, PLEASE no one ruin it by making it political.
I think I speak for many in that I hope to read Sharpsticks opinion.
I have limited experience with ACA plans but it seems like when kids have plans through an exchange they always have a VCP. I don't take Eyemed but we file VSP. I guess it is good for parents that the exam and glasses are covered. It is not good for me because they only cover Otis and Piper frames and I have to us a VSP lab.
Aren't healthcare cost already through the roof?
Nothing will impact the eye care marketplace as much as the ACA, therefore, rational discussion is vitally important to all of us. I don't think that we should just sweep this under the rug and hope that we will go forward, business as usual. The impact of the ACA will have a profound impact on our personal and professional lives and we should not hesitate to bring these issues to light.
Just be nice !
Health insurers don't generally have the infrastructure to deliver vision care. Voila! VSP and EyeMed do! Ergo they contract with them to provide it.
I have a love/hate relationship with this whole thing from a business perspective. My office is being flooded right now with people with either Medicaid, ACA plans, and HIP 2.0 which is the state's "shared costs" expansion of medicaid.
In some ways I love it. Great exam reimbursements since all are based upon a decent percentage of Medicare rates. Reimbursement for materials vary, but it would not be hard to create a satellite office just to cater to this crowd. Those with the ACA and HIP are often willing and able to upgrade, I can do the lenses in house, so can be lucrative.
However, it IS another VCP. Granted all these people have medical coverage as well, and we have seen several for medical issues. It also takes us totally in a different direction optical wise than what we have been working on over the past year.
I can see the VCPs pushing to specialize in the eyes, the way dental insurance does. Not only cover your routine vision and materials, but expand those diabetic plus or primary eye care type plans like VSP has, and cripple the medical model by reducing reimbursements significantly compared to a true major medical insurer.
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
Wow, Jubes, that's insightful.
Imho, Vision plans are here to stay. ..Aca or no Aca.
Ohhh, there may be a few more restrictions on them like forcing in house labs on us, or forcing discounts on uncovered items. And the plans may have more trouble morphing into medical Eyecare plans, but they are not going away.
Now that the ACA is here to stay and individuals under 19 are covered for vision, it would be the ideal time for offices that rely heavily on vision plans to adjust their business plan.
We opened up our office February of 2013 and this is a really great description of what we saw, and continue to see. We are an office in an area with a really mixed bag, the majority of which are your recent immigrants/very hard working young people. It results in a sizable amount of medicare plans.
I think the key element is understanding exactly what the state/national provides reimburse and provide to the patient. Some have hardware allowances, others have exam only. As long as you can educate the patient about their benefits, you almost always are in the green. It results in a relatively satisfied number of patients.
I'm willing to adapt. It's a strange time, maybe a good one.
Dylan, you mean Medicaid. I'm glad you're willing to adapt. We don't write the rules, we just respond to them. We'll probably go with the flow to test the waters. If we don't like it, we're dropping out.
Sorry. I seem to continually swap my use Medicaid-Medicare in all the wrong situations.
Medicare - You care for the elderly
Medicaid - You give aid the poor
Yes, educate the patient, but even more important, educate your staff! Two years ago, we became overwhelmed with the myriad of plans and changes assoicated with them. My operations manager was putting out updates, and the other managers were helping, but we were still having reimbursements slip through the cracks.
I ended up hiring a full-time insurance administrator. She was one of our optcians, but had an insurance background. I took her off the floor (in fact, I sent her home) and she does nothing but take care of the insurances. She updates the offices on changes, breaks the changes down into easy to understand English, and instructs each employee on how to pre-authorize, submit, and instruct the patients as to what their benefits are. No more guessing, and hopefully, no more missed opportunities/profits.
When I was a sales rep, back in the late 80's, I noticed an attitude among Ods and Mds, that their dipensaries were afterthoughts. Among the opticians, 3rd party plans were the afterthoughts, as the money was made on the cash pays. Today, there are no afterthoughts, and every penny is earned. There is no such thing as low hanging fruit, and you've got to be able to maximize the potential of each person walking through your door.
Ophthalmic Optician, Society to Advance Opticianry
I look for VCPs to go retail, quietly at first and then full speed.
VCPs are already going retail. All 3 major players have retail locations, and they will be milking those for all they are worth. I can still see them wanting to keep a toe if you will in the private sector. I can definitely see VSP especially expanding their primary eye care, and diabetic programs to entice the major medical players, such as Anthem, that they should farm out all things that fall under the purview of optometry anyway, to them. Perhaps reserve the out of office surgical procedures to medical, but the majority of glaucoma, diabetic, infectious, and medication management to VSP allowing them to pocket a portion of the stream by taking it from the providers.
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
There are currently 1 users browsing this thread. (0 members and 1 guests)
Posting Permissions
Reply With Quote
Bookmarks