Article

THE MANAGED CARE CONUNDRUM

Got concerns about managed vision care? Here, we look at how it’s influenced corporate O.D.s’ practice models

JIRSAK / SHUTTERSTOCK.COM

In our industry, we have seen a shift of many younger O.D.s choosing to work for a corporate optometric location over trying to enter private practice. And it’s understandable—with increased student debt, lower insurance reimbursements, and an increasing competitive playing field, it makes sense that younger O.D.s gravitate toward the employment or sublease model of corporate optometry.

However, O.D.s in corporate optometry models should be aware of the impact managed care plays on the business. Research shows that sublease businesses in corporate optometry often have 40% or more of their patients on managed care plans. This number has grown tremendously over the years, and it will likely continue to grow.

This fact makes for a complex road to navigate in corporate optometry. Here, we examine various business models for corporate optometry and hear from optometrists in the field about the real-life, current impact of managed care and where they see it going in the future.

The Employment Model

Being employed by a corporate location can be attractive for younger, millennial optometrists as private practices (with their overhead costs and decreased reimbursement rates) may not be able to compete with the salaries and benefits that are given in corporate optometry. New grads who prefer the employment model will seek corporate optometry positions.

STEVE UDESKY, O.D.

REAL-LIFE IMPACT

Steve Udesky, O.D., is a fill-in optometrist for For Eyes in Illinois

“Managed care has influenced optometrists’ career paths. I believe it has resulted in limiting O.D.s to more routine eye care and over a decade of stagnated reimbursement rates.

“The employment model offers a low-stress opportunity to make a good living and have other benefits that are unavailable to those who chose to lease or own a private practice.”

The Medical Model

With managed care playing such a large role in their patient base, decreasing reimbursements will force corporate O.D.s to adapt and evolve. One of those evolutions? They will embrace the medical model.

This model can provide a higher patient retention rate and higher reimbursement rates. Many corporate O.D.s have the technology to diagnose, monitor, and treat medical patients. I believe that as optometry evolves and scope-of-practice laws change, we will see more medical-based optometry in our future.

LEE FORD, O.D.

REAL-LIFE IMPACT

Lee Ford, O.D., subleases from two Walmart locations in Alabama

“My patient load is about 25% to 35% vision care plans. If you count Medicare and Medicaid, I see over 80% managed care. I have my staff pull medical coverage on every annual so that if there is a significant finding during the wellness exam, we are able to discuss the cost of the next visit in the exam room.

“I have found that this streamlines the encounter. Patients are more likely to follow your orders if you let them help in making out their treatment plan. I also use a lot of screening tests on every annual wellness visit (OCT, FDT, specular microscopy, blood pressure, and dry eye questionnaire with tear testing as needed) to help patients understand (compare the ‘normal results’ to today’s) what I want them to come back to check on and why. You can’t find a problem if you aren’t looking.”

The Private Practice to Corporate Model

With the expansion of corporate opticals and increased competition, the corporate optometry model will become more popular. This shift is due to the influence of managed care, its lower reimbursement rates, and the increased costs of running a business today.

LAURIE LESSER, O.D.

REAL-LIFE IMPACT

Laurie Lesser, O.D., practices with South Florida Regional Eye Associates in the Miami/Ft. Lauderdale area, affiliated with America’s Best Contacts and Eyeglasses

“I think optometry is experiencing what medical doctors in all fields have been dealing with for many years: the realization that we need to see more patients to compensate for lower reimbursement rates. And corporate optometry practices are often better suited for the level of efficiency and patient flow that is necessary to stay profitable.

“Unlike corporate O.D.s, private practice O.D.s are affected not only by lower reimbursement rates on exams but also on prices and sales of glasses and contacts. With these lower profits and increasing competition from corporate opticals and online sales, starting a private practice cold is becoming increasingly difficult. I agree that more O.D.s will start to go into some form of corporate practice.”

IBREAKSTOCK / SHUTTERSTOCK.COM

The Future of Optometry

In order to evolve and stay relevant, optometry will most likely continue to see more consolidation in the future. Consolidation through private equity will continue to shape how new graduates make decisions about their career choices.

And, with recent mergers and acquisitions in the industry, we will also begin to see a shift in how optometrists practice in a private setting and corporate optical setting. Corporate opticals will continue to make acquisitions of services and products for vertical integration.

Certainly, there will continue to be mergers in the industry that will influence how optometrists make decisions in their practices and how young O.D.s choose career opportunities. The future is bright, but the path is more winding than ever before. COT!