I just received an invitation to join the VSP Loyalty plan; year-end rebates for meeting four goals. Three I understand; sell a certain number of Altair/Marchon frames, sell a certain number of house-brand lenses, have an active E-Web site on VSP's on-line sales site.
But the fourth has me puzzled. "Submit at least 5% of your WellVision claims with an Eye Health Management condition". Does VSP now want access to our patients for marketing medical stuff? I don't get it.
Its seems pretty clear VSP is moving towards competing with medical insurance. They seem pretty leaned towards the optomap too. I guess someone over there decided it was superior technology. Most O.D.'s I know feel this is a dis-service to them, there is a preference to billing to medical. It could give M.D.'s another round of ammunition to pull O.D. off medical ins. panels - they'll use any angle they can find. I guess its great if the pt. doesn't have maj. med, but that is rare. I can see VSP offering it, but they are doing more than just that, as you mention above.
racethe1320 - as the closest to a VSP spokesman I'm aware of here on OB, could you shed some light?
Just like they want to know if patients have diabetes, hypertension, or high cholesterol...hmmmm.
Maybe they plan utilize "pre-existing" conditions if pt. lets plan lapse....
*snick*Originally Posted by finefocus
On the eyefinity site, you must check a box with a medical condition or none. As Austin says perhaps they are wanting to move into "medical eyecare." They have some plans which have extra benefits for diabetics, and other problems. Also some programs a few years ago with Cigna I think to cover some patients who don't have any cigna providers nearby. However, reimbursement from commercial insurance will ALWAYS be more than VSP could ever think about paying out. IMHO.
Ya - we are of the opinion that where VSP is going is a dangerous, slippery slope. We're worried that eventually VSP pt will demand that their VSP is billed, and Ophthalmologists will demand (continue to demand that is) that they be taken off maj. med. plans - something that O.D.s have put their blood, sweat and tears to earn. We spend an in-ordinate amount of time educating pts. that not all eye exams are routine because pts associate their VSP ins. with "just an Rx". The question now is what is VSP going to do to educate pts. that their vision ins is for more than just an Rx, and... are they going to keep up with Medicare rates or undercut them and undercut the profession?
It's a selling point to their clients that does have a solid basis. I'm sure there will still be some skeptics, but hey, that's what makes this place go-round.
http://www.prnewswire.com/news-relea...119243874.html
Costs for the plans are SIGNIFICANTLY higher for the client and employees too.
Have you been to any of their benefit fairs with clients? There's a ton of education being done as they do a slew of events. They don't just approach the employees with Rx related information. They discuss the importance of vision care and how routine visits to their ECP can detect early signs of diabetes, hypertension, etc.....it's an interesting approach as it's something EyeMed absolutely can't even talk about.
except, Eyemed and other insurance companies have already jumped on the bandwagon of vision being an important part of health..
Eyemed and Davis I both know were also inquiring about patient conditions. So they too, can claim that they are working to help ensure an employee's total health, by reminding that diabetic patient that they need yearly exams..
"Some believe in destiny, and some believe in fate. But I believe that happiness is something we create."-Something More by Sugarland
That, my friend, is an adverstisement. lol...
duplicate post.
That may be. Maybe the pts are not listening or they are doing a really bad job. Its seems up to us, that guys they are sending these pts too, to take time out, educate and hope we can convey the message in 5-10 minutes. Hopefully they continue and don't give up, because its a long road ahead for all of us involved. I guess they must do a lot of pt education in CA, where they are based, but don't see it around these parts. I'll be sure to ask some of my corporate friends where VSP is a co. benefit, next time I see them, to find out if they are hearing this.
Really? I thought it much better to just link the article than type out a post saying essentially the same thing. It provides clarity and then some to the question asked. Damn me for doing that.
[/QUOTE]
Are you a Doc or an Optician? Either way, you're telling me that working in the health care space you don't feel you have a responsibility to educate patients on things beyond the Rx? What is your role then?
I can't speak regionally as I'm not out west. I do agree it's a tough road and not an easy task for a managed care company to accomplish. Even more difficult when their main competitor is promoting price and retail and driving focus on Rx's and frames vs patient well being. Open enrollment is going on right now. Many contracts are up for renewal too. I've talked with many of the Benefit Managers for the large companies that my patients work at. Nothing new, they are looking at costs.Hopefully they continue and don't give up, because its a long road ahead for all of us involved. I guess they must do a lot of pt education in CA, where they are based, but don't see it around these parts. I'll be sure to ask some of my corporate friends where VSP is a co. benefit, next time I see them, to find out if they are hearing this.
Whatever you are doing in terms of educating the patient, I'm sure it's more than the retail outlets. You've said it before, you don't see the likes of Pearl or LC as a threat because you are able to deliver better quality care. Kudos. I do believe that.
Probably they want to get in on the medicare reimbersed testing strip, catheter, etc. racket. Possibley they want to disallow eligability to some patient's but I doubt that they are a little too greed oriented for that.
Chip
OK, here's your point so far:
The patient who has an eye exam may find other medical issues not directly related to vision;
VSP does a lot of "educational" events;
VSP clients like to know about their employees' health.
In what way does that argue for sharing patients' personal medical information with their employer, VSP, or anyone else?
Doesn't that put us in violation of HIPPA requirements?
VSP does glasses, not medical care per se, and has no need for, or right to, that data.
Paying me to provide that data is a form of bribery, and my compliance a form of prostitution, by my lights.
Or do I just fail to understand the noble motives of the third-party healthcare business?
The idea behind the program is that it focuses on the early treatment and management health conditions related to both eyes and overall patient health. Do you not see a value in that?
I see a very good return for my patients who receive their exam reminder letters. These go out to all my patients identified with Diabetes and Diabetic Retinopathy. How are you currently handling this in your office?
The program as a whole flat out supports and quantifies Opteometry's participation in medical care that someone earlier mentioned they fought so hard to be a part of. Do you disagree that it's important to the community of OD's to do this?
How so? They aren't sharing the names and personal details, just the medical data they collect from VSP members and thus allows for significant cost avoidance for VSP clients. Again, it's a selling point. All companies want to know more about the health of their employees, whether they smoke, are abuse drugs, etc...so that they can tailor programs around their health and cost savings. Do you have a problem with that?Doesn't that put us in violation of HIPPA requirements?
My son works for a company that provides lower insurance rates to employees that don't smoke, are not over weight and they also cover his health club membership.
Really? So you determine if they have the right to help out their clients by providing data that's legally allowed to be collected? They don't force ECP's to provide it. They are legally allowed to ask as they do. You're choice. I like the fact that I demonstrate my involvement in their total healthcare vs just their eyes. I use it to help differentiate. Do you not see value in promoting total health care in your practice?VSP does glasses, not medical care per se, and has no need for, or right to, that data.
You're entitled to participate or not. Your call. I'll gladly enjoy the $2-$5 per patient. Do you not ever wish you had a few bucks more per patient exam?Paying me to provide that data is a form of bribery, and my compliance a form of prostitution, by my lights.
I can't comment on your understanding of the program. Perhaps you don't understand it? If you have any questions, don't take my word as gospel. I'll tell you the same as I've told others here on various subjects; call them, and report back. They aren't hiding anything as you seem to be implying. Are you up to contacting them and reporting back for the entire board to learn from?Or do I just fail to understand the noble motives of the third-party healthcare business?
Taken right from their site
VSP Smart Data ManagementSM collects broad HIPAA-compliant health information on all VSP members when they visit a VSP provider. Specifically, we collect data on diabetes, hypertension, high cholesterol, diabetic retinopathy, glaucoma, and macular degeneration.
We share this medical data with health plans and/or disease management vendors to aid in overall disease management efforts. Since 2005, nearly 2 million VSP members have been identified with chronic conditions. Additionally, of the thousands of people with diabetes we’ve identified, 20% were unknown to the health plan or disease management company as having the disease. As a result, these members can now receive help in preventing their serious condition from advancing."
Last edited by racethe1320; 08-29-2011 at 04:40 PM.
how much access does VSP want, anyway?
VSP is not reducing costs nor are they providing a service to VSP patients in which they don't already have. If VSP is to pay for this, it will have to increase premiums. Most VSP patients already have this covered under Major Medical. Its not doing anything, but increasing the costs of vision insurance while lowering reimbursement rates and undercutting the profession, not to mention, doing it in an invasive manner.
You make replying very difficult. Why not just use the forums quote feature vs typing in red whereby formulating a conversation is more difficult? Just curious. I'm not going to copy and paste, I'll just leave it at this: If you don't wish to participate in the program, then don't. If you still feel there are some privacy issues you can't live with, don't participate or do as I noted and call VSP and clarify, then report back. I think bigger fish than you have already insured the program is compliant. If you're really that unhappy with VSP, then drop yourself from the panel or work somewhere that isn't on the panel. No one is forcing you.
You don't see how the study conducted proves the benefit of the program? I suppose we'll agree to disagree as will their clients who see the value in knowing and saving. I see patients all the time that see me yearly yet don't go to thier familiy doctor for a full checkup but every several years at best. So in the end, they may "already have" a benefit, but they don't use it. Premiums aren't that much for vision care anyway. What $5-$18mo vs several hundred for medical? Premium cost to the patient isn't the biggest concern for patients. Cost to the employer is but then they are more concerned with the understanding and benefits of the EHM program which in turns saves them more than any additional cost added to the premium would impact them.
EHM is in no way undercutting the profession. If anything it fully supports Opteometry's participation in medical care that you mentioned being so concerned about. The interesting part of this conversation is everyone is so hell bent on this invasive privacy HIPPA related issue yet it's been fully addressed by VSP and the powers that be yet you still disbelieve?
The other aspect that's funny is I went to the grocery store tonight, bought food, some OTC meds and a presecription medication. On that transaction at the pharmacy counter I swiped my frequent buyers card and the same at the register for my OTC stuff. I wonder how come the pharmacy always seems to send me reminders, coupons and related products to the meds I'm buying as does the store for all kinds of stuff. Do you think they too are using my information and data? Do you think medical plans that reimburses patients communicates statistical data to their clients based on the results? Sure they do. What VSP Is doing is no different than what is going on in the world of medical managed care programs and perfectly ethical and legal.
Last edited by racethe1320; 08-31-2011 at 12:03 AM.
Here's the problem with your pro vsp argument.
First, VSP commisioned the study. They then use the study they (vsp) paid for, to spin as a public relations role out to companies.
For those on here who haven't looked, check out the vspeffect.com.
Last edited by OHPNTZ; 09-02-2011 at 12:50 AM.
Here's the problem with your pro vsp argument.
First, VSP commisioned the study. They then use the study they (vsp) paid for, to spin as a public relations roll out to companies.
For those on here who haven't looked, check out vspeffect.com.
Watch the video, VSP's commercial continuosly uses thw term "we" found the health problem, "we" shared this information with your doctor...ummm no you didn't.
I found the problem. I and the staff used our uvaluable time to contact a doctor's office, write a letter, fax or email, and pass on any relevant information and/or photos.
Here's what VSP did. They discounted what I normally charge for my services. They also discounted what I am normally reimbursed for product. This in turn requires me to see more patients in the same amount of time (your words race). This requires me to delegate more, and require more staff. Then they offer a couple of bucks (literally) so they can get more medical info...which they can supply to their commisioned study. They will use the increased reporting (since some optometrists will salivate for 2 dollars), to then commision another study where they claimed they are now more efficient at detecting these health ailments. Then they conveniently take credit for it...they may leave you warm and fuzzy by mentioning they are nit for profit, too.
I think I should commision my own study. It could show employers that their employees would get the same diagnosis, without their eyeglass discount plan. The $216 per yr ($18 per month), plus additional $25 copay could be applied to materials of the patients choosing, and the medical insurance would pay for the exam.
The results...savings for the employer, more face time with a patient due to less number of exams to offset the discount offered by VSP, better reimbursement for my time, and the exact same, if not better, care.
Thats the "without VSP (or any other vision plan) effect.
There are currently 1 users browsing this thread. (0 members and 1 guests)
Posting Permissions
Reply With Quote
Bookmarks