In the six years that I’ve been writing this column, I’ve always dedicated it to topics about medical coding and compliance. This column is going to be different. This time I’m asking you for answers.
Who’s Minding the Patient?
Managed vision care plans (MVCP) have a significant impact on the financial wellbeing of most optometric practices. Many ODs have voiced to me their desire to sever ties to these plans—but they are fearful about the economic consequences.Many articles, in this publication and in others, have detailed the rationale that should be applied when joining and renewing your contractual obligations with these carriers. That said, I’m more curious about your thoughts when these MVCPs begin to restrict your ability to recommend and prescribe what you believe is best for your patients. We’ve effectively fought this battle with pharmacists who turn our medication prescriptions into less efficacious generic medications. But, what do you do about the MVCP that tells you what type of spectacle lens or contact lens you must prescribe? After all, if the future health care system is going to grade us, as providers, on patient outcomes, shouldn’t we control the product we prescribe to obtain the best outcome?
Who’s Managing Who?
As MVCPs become more vertically integrated, this appears to be the direction that we’re all headed. VSP, for example, is now far more than a benefit plan; it owns and produces ophthalmic frames, EMR and practice management software, and spectacle lenses. Luxottica, one of the largest frame manufacturers in the world, owns EyeMed, one of the major players in the MVCP space. WellPoint purchased 1-800-Contacts, and so on and so on.Does this concern anyone but me? I realize that there are a multitude of pressures on the individual practitioner, and many of these changes put upon us are cloaked in “rewards programs” and “incentives.” It makes me wonder: When will it end? Where is the line drawn when the doctor ultimately decides what is best?
As the lines get blurrier and blurrier, the best care that we want to provide our patients could be restricted by the contract that we now have to uphold; be mindful that it may not be the contract that you originally agreed to, but one that has been unilaterally modified. Of course, you could opt-out of your provider agreement; however, that might feel like financial suicide for many practices. What do you think?
Let Your Voice Be Heard
So, here’s what I would like to ask of you: I’ve constructed a very basic seven-question survey (seven is my lucky number). It should take you only about three minutes to complete, but your honest responses—the good, the bad and the ugly—are all very important. I’ll publish the results in another column soon, so you’ll have a timely snapshot of this intensifying issue. Thanks in advance for taking the time to respond to this questionnaire, and be assure that your responses are completely anonymous.Please send your questions and comments to CodingAbstract@gmail.com.
Take this quick survey on issues related to managed care vision plans. Thanks in advance for taking the time to respond to this questionnaire, and be assured that your responses are completely anonymous.
