Monthly Archives: January 2014

How To Build An IPA

What is our plan?  We are simply copying a plan that has succeeded all across the USA.   Business-PlanHere it is step by step:

  • [ x ] Done –  A Core leadership Of Volunteers are formed which donates their time to create a unified organization with a legal operating agreement and form an LCC.   Goals, benefits, financial value and membership/ownership dues are defined!
  • [ x ] Done –  A presence is created to share on the Internet and more distant  expansion development core leaders are added to help share the vision all across the state of NY.
  • [ x  ] In Progress –  Volunteers Contact Colleagues.  Volunteers who have read our blogs and see the vision and value begin calling their colleagues to get them to join and create the UNITY and empowerment we offer! They are invited to an opportunity meeting!
  • [  x ] In Progress –  An opportunity meeting is held, On-Line to inform new prospective announce_invite_a_friendowner/members and give them an opportunity to join and  kick-start the group financially. One was held Feb 9th 7:15 PM on-line! (More to come!
  • [   ] In Progress –  Financial Benefits begin to grow.  As each owner/member uses the preferred vendors, dues becomes less and vanishes, instead becoming a profit!  Using our recently acquired lab begins to produce very significant profits (comparable to Luxotica) so that you can take care of your patients with pride and professionalism and not become a factory like many commercial chain stores have done!
  • [   ] In Progress –  Plans are sold and ACO, PCMH negotiation begins.  With cash flow we will hire, train and begin using a professional salesman to sell plans!  These will be prioritized first for make-money-onlineowner investors whose voice is listened to , though members will naturally benefit from these too!  Our organization,  like many other VCD groups, will be able to offer services to ACOs and PCMHs to provide medical evaluations and care especially for diabetics, hypertensives and other services.
  • [   ] In Progress –  We are statewide and thanks to other independently owned IPA’s Nationwide. We will now find large nationwide companies signing up for care in one state and that will be a benefit to all states.  Minimum fees will be agreed upon at our national meetings and adjusted per state for cost of practice.  This is already in planning.  Note:  All IPA’s are shareholders in the national IECP (Independent Eye Care Providers) association. It is ours and we send representatives to the meetings as we have done already in 2014!

Want to learn more?  Click on all the hyperlinks in the article above!   Definitely join us for our next virtual online meeting!   Want to contribute to the effort?  Register for potential membership and communicate in that process how you want to help!

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What is the difference between the NYIPA and VSP, EyeMed, Davis

IN TWO WORDS UNITY AND FREEDOM, YOURS!

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The NY State IPA, NYIPA, is an incorporating business owned by its member OD’s and in NO WAY owned or controlled by any national organization!

IPA’s in every state are self contained businesses owned by its members with two goals:

  1. Make its membership in becoming much more profitable
  2. Assist its membership in ACO, medical care inclusion!

Each state IPA, may choose to utilize services provided by our national infrastructure to dictatorassist us in processing and billing claims and other needed services. These corporate infrastructures, are owned by ECPA (Eye Care Provider Associations) of which the ownership is the State IPAS! UNLIKE a VSP, EyeMED or DAVIS vision plan that will dictate fees to you and sell low paying plans that you must by contractual obligation accept be in their Network, we make our own financial decisions!

What is VCD and ECPA? When Rome built highways to empower their nation to control their destiny their soldiers were given unparalleled control of their destiny. In a similar manner, VCD is a team of businesses, have come together to build the super highway to Optometry’s empowerment; yet, they then sold that ownership to state IPA’s that empower them, make their existence meaningful and viable and prevent the birth of another VSP.

We as a UNITY of independently owned state businesses (IPAs), not only benefit by being able to sell and provide services such as vision plans on a local and soon national level but like VS (Vision Source) do pay back Vendor Rebates and from our recently acquired lab, huge financial opportunities to compete PROFITABLY with the likes of EyeMed, VSP and Davis without having to turn your office into a factory! There is no “franchise” like a VS that you must join or pay 2.5% of your gross to! There is simply a cooperative effort of state owned businesses and service companies that succeed by give each of our states man with car key outsideownership as shareholders. We give our fellow ODs the Key To Their Freedom, we are them! I am a volunteer because I believe in free enterprise and see how oppressed my colleagues are.

A few years ago an OD came to me to be hired and to become a future partner. He worked for me a week and then we separated by mutual consent. He was terribly in debt and needed to make a lot of cash quickly! He said I had a “Dream Practice” but he would not own it soon enough. I met him a few weeks later and he had hired on as on OD in a big box store working for a “lease holder.” He told me he had been required to sign an agreement that he would see 35 –> 50 patients daily and NOT do any medical care but refer out medical issues. I said, “This is going to burn you out and kill you! Why would you do this?” He said to me, “Yes you are right, but I can see that they do not like the lease TreadMill Screenshot from 2014-01-28 10:29:05holder. They are willing to give me the contract in two years. At that point I will employ ODs who will work in this factory like environment and I will make the money I need and I will not have to be a factory worker and burn out! This is worth the pain and suffering of a few years of insanity!” I choose another path!

By legal design and operating agreement, State IPA’s and our National Infrastructure will never become another dictatorial, self profiting, VSP. We are here to make Independent Practitioners able to compete. We are volunteers who sweat and toil to start a financially viable business in every state, that you may own, take risk with and earn profit from. We are freedom!

Dr Joe Ross, president NYIPA

Your Opportunity Meeting To Join Us 2-9-2014

Inline image 1Greetings and welcome to your NYIPA membership opportunity meeting!

YOUR OPPORTUNITY MEETING:   on Sunday Night,  February 9th at 7:15 PM Est,  will be a chance to see if your practice qualifies for NYIPA membership, ownership and empowerment that the  UNITY of  NY State Private Practice ODs are already creating through the NYIPA. 

WHY WE WILL HELP YOU PROSPER:  You will get to learn how we will make you more profitable than you could ever have expected and catalyze your connection to ACOs and PCMHs that might otherwise take away your medical patients! Our Must Read Posts will help you understand these critical issues before the meeting, so read them!

LEARN BEFORE THE MEETING:  be sure you come to our site and READ our blogs and educational materials at NYIPA.ORG  Please write down any questions you may have as you will have a chance to ask questions! At Least read our Must Read Posts! On the upper Right  of our front page. If you have colleagues that you care about,  share this invitation and tell them to REGISTER for possible membership Before The Meeting! 

POWER IN UNITY:  Remember your colleagues are not your competitors;  there is power in Unity and all of us who qualify will all have a chance to OWN the NYIPA and is profits!  This is not a VSP and never will be!

180 SECONDS OF WHY!  Click Here –>   http://youtu.be/dgcurHWOXXM

 

HOW TO JOIN THE MEETING:

We will be hosting our meeting on-line  using GoToMeeting.com

Here is the meeting date:  Sunday February 9th,  7:15 PM Est.

1.  Please join my meeting with this link:  https://www1.gotomeeting.com/join/986638032

2.  Call in using your telephone.  We have noisy feedback when people use their computer mic.  Dial +1 (646) 558-2100   

3. The meeting Access Codeis : 986-638-032 

4) Audio PIN: Shown after joining the meeting

5) Meeting ID: 986-638-032


Reid Nelson of  Vision Care Direct  (VCD) will be hosting our meeting. Reid Nelson is one of the Founders of VCD.  VCD,  has helped create powerful, financially successful IPA’s in over 1/2 the Country and more are forming every day! This is an opportunity you will not want to miss!

Changing the Face of Managed Vision Care – One Doctor, One Patient, One Agent at a Time

 

Dr Joseph Ross, NYIPA, President,

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Getting Off The Treadmill!

The NYIPA,  with the support of IECP and VCD,  has one main goal: Getting all of NY States private practice optometrists off the Treadmill!  What is the treadmill?  It is low TreadMill Screenshot from 2014-01-28 10:29:05reimbursements and high volume forced upon on us by very profitable business that are like leeches on the backs of Optometry.  These have names we all recognize, like EyeMed, Davis,  VSP, etc.   They bring patients into your office but with fees too low to sustain patient health centered eye care practices!  They do this because you have NO voice in their financial decisions and share in none of the profits they earn.

The explosion, across America,  of IPA’s using the VCD,  IECP  support system is catalyzed by the Design Of The System that makes YOUR IPA,  an owner on the state level and an owner on the National Level, of our support system.  In other words, it will never be another VSP that promises to support OD’s but loses its nonprofit status, in court, when it rakes in millions of dollars while paying nothing back to ODs.

Unlike National buying groups,  that charge huge franchise fees,  Your IPA,  has  ownership fees and dues to sponsor YOUR owned IPA at start up.  However, like other businesses as we grow these are expected to vanish and become your profits!  The profits,  when earned, are yours and do not belong to a National Franchise, as in the case of  Vision Source (VS).  If you don’t want  to be controlled like a rat  running in a cage, than UNITY  through the NYIPA is the answer! That is what we are all about!

As the NY IPA acquires its final legal status   (we are incorporating) ownership will be man with car key outsideoffered to those who are first to apply and are willing to help fund its creation.  Ownership will not offer any great financial rewards though it will grow in value over years and give you an immediate voice in our major decisions and may offer some small priorities as in selling plans in your area first. Our state plan, our National Plan, and the operating agreements are worded is to treat owners and members with equity and as such never be a VSP.  This is, after all,  an organization to help private practice OD’s compete with the likes of Luxotica, which we will do and are beginning to do now! Our goal is to return profits and great contracts to our owners and members everywhere.  We will also be your catalyst to expedite membership or even the creation of ACO’s that guaranty you opportunities to participate in the coming medical changes Obamacare has fostered.

Criteria for membership at this point (though there may be changes)  is simple:   You must be a licensed OD who owns their  own practice,  have controlling ownership of your dispensary and be able to provide 24 hour emergency services (as may be required by ACOs and PCMHs).

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An ACO Moment?

As ACOs (Accountable Care Organizations) and PCMHs  (Patient Centered Medical Homes) grow in every state they are looking for teams of doctors to contain healthcare costs and provide Affordable Care to patients.  Cost containment looks more and more about keeping patients out of the hospital!

There are two immediately apparent  ways to do this.  One, which is an optometric opportunity,  is to keep the patient healthy by early diagnosis, monitoring and preventive accountable-care-organizations-lights-camerascare and the second is by triage that keeps the patient out of the hospital (which like owning a boat can be an endless money pit).   Optometry can play a major role by diagnosing and monitoring systemic disease like, retinopathy that leads to blindness from, hypertension, arteriosclerosis and diabetes. Optometry can also become an arm of a  Pre-ER triage system for those not needing surgical eye care.   It is reported that  a  PCP receiving good reporting from a vision care specialist, can cut $6,000 / patient /  year from medical expenses. Not to mention the much greater costs of subsequent strokes, heart attacks and disability!

This this NBC video below,  briefly points out another opportunity which can monetarily motivate the patient.  This is something I believe has died in the current medical paradigm that diagnoses every failure of patient responsibility as a disease to be overcome with surgery or a pill.  Here is how patients acquire financial risk in entering a hospital!  It is both a warning to patients and suggestive of a possible need and opportunity to  patients and doctors, outside the hospital,  to get more involved in their own responsibility for keeping costs down.   Note some interesting references to the value of vision screening below the video!

NBC NEWS Screenshot from 2014-01-28 08:46:38

References:

  1. Evaluation of the expanding access to diabetic retinopathy screening
  2. Tobacco cessation and smoking’s impact on health care
  3. Preventive Eye Care in People With Diabetes Is Cost-Saving to the Federal Government

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Pay For Performance VS Pay For Service

What does the new phrase “pay for performance” mean?  It certainly does not mean pay for services provided.  It is a term whose definition is in flux.  It essentially means that someone is going to read your EMR records (or a computer algorithm will) and decide if you have “performed”  better or worse than other docs in similar care.  If your performance is worse you will be paid less; if it is better you will get a  bonus.   There are very divergent opinions on the value of this growing and currently be tested system.   It sounds good at first sight  but is it?  Performance is measured by “outcomes.”  Outcomes Medical fraudoften means how quickly a patients issues are resolved and with how little services.  So providing less services and quicker resolution will ideally be rewarded.

At the end of this post you will see several hyperlinks with articles you may choose to read.  For now let me share one interesting viewpoint.

Unless things change, it appears that the quickest, cheapest solution is drugs. Symptomatic relief.  It is true that long term this will not be the best as many chronic diseases are lifestyle created and so require behavior modification for long term results.  Some ACOs are betting on providing counselling but  will the time spent be rewarded?  If so this could be a real benefit!  If the present situation is any predictor of the future, I would be skeptical but still hopeful.  Skeptical because HMOs,  Health Maintenance Organizations,  are not about health maintenance because they know a company will drop them in a year for a new low bidder!  They have no long term interest in your longevity.  Like Wall St. traded corporations, that dances to the quarterly review of of investors, HMOs have no real vision of health that depends upon patient longevity.

It is a new paradigm   and a positive sounding concept but can it be made to work?  Will we provide counselling and education?

Counseling - In TearsI reserve judgement and hope it can. Nevertheless I suggest we  recognize that adding another layer of bureaucracy to medical care,  those assessing outcomes, can only mean adding another expense that comes out of the doctors pocket.   Will it come down to drugging away the symptoms, as we currently do in America or resolving long term health issues by counselling and lifestyle changes?  Perhaps putting the burden of the expenses on the patients themselves may be a solution, that is not often discussed and certainly not popular with those who are elected to office.  These patients  may need to pay more for a policy if they smoke or choose to be obese! These issues are the biggest expense in America as they relate to heart surgery,  stents, diabetes, strokes, joint failure of knees and hips from obesity and much more.  A shot or a pill will not fix it and there are a lot of powerful food lobbyists and drug companies out there.    What does this have to do with optometry’s future?  Lots!

Can we doctors unite in this new health care paradigm and make a difference through ACOs and PCMHs?  Only time will tell.  We at the NYIPA plan to help you  be involved as this is your future.  We can easily diagnose diabetic retinopathy’s  progression or regression. We can and do take BP’s and weights and photo document nicking or its regression.  We will be part of the PCPs team that helps the PCP get a good rating by knowing better how their patients are really doing.  Where there is a challenge there is opportunity for doctors who are untied by a network. The NYIPA, is your network and Unity is your empowerment!

References to opinions of interest: 

  1. Should Physician Pay Be Tied to Performance?
  2. Paying Doctors For Patient Performance
  3. Will Paying Doctors for Performance Improve Patient Outcomes?