The new health care paradigm is all about solving problems for large insurance companies that are entrusted with millions of lives under the Affordable Health Care Act often known as ObamaCare. Large ACOs are forming frequently around hospitals and the doctors that service them. These ACOs will receive the patients and you must be part of the new paradigm to play.
At a meeting last night I had the privilege of talking with a very bright lady, past WRPOS president, Marilyn Mann, who asked a great question. She said, in NY where we don’t have oral drugs, how can we participate? The answer is the opportunities we will create. You as an individual may not qualify but now imagine a large network of hundreds of ODs and OMDs who will soon form our IPA. How might this entity be empowered? For one thing it can contain local PCPs, P.A.s and Nurse Practitioners, because we are not talking about just “vision care,” we are talking about medical eye care. The MOST important thing to organizations like WellPoint (with over 80,000,000 lives in its portfolio) is how easy we make their financial success. So now imagine a network of primary care ODs whose goal is the prevention of major vision problems and keeping patients out of the very costly ER at hospitals. What if we strategically placed PCPs in our network with whatever P.A. Or nurses they need and interchange data (EMR) on the status of diabetic, hypertensive and other critically ill patients. Could we keep them out of the ER? The WellPoint speaker in Arizona recently suggested that we might even get paid for dietary and tobacco cessation counselling! Why not? We are in a position to see the consequences in the retina! What if we strategically locate a Triage person in the ER, who could decide if the incoming patient could be seen by an OD, OMD or have to be in the ER? When you form a team of professionals, you can utilize the exceptional skills of all to help each and every one succeed. This is just one idea but this is what the future of American medicine will be made of, new creative ideas and organizations that can cut health care costs and make life easier for groups like WellPoint!
I spoke to a paramedic who rides an ambulance up in Ulster County the day prior. She mentioned that each admit to the ER costs an average of $30,000. I asked, “What if our professional network could triage all the eye injuries that did not belong in the ER out to our network for care?” She said, “if you earned $5,000 for the service to each patient it would save $25,000! ” That would be great!
Could you do that? Possibly that and more. Imagine taking all the heavy duty tech out of your offices such as OCT, Fields, Photography, Topography, etc, and placing it in “Patient Care Centers” possibly with the Triage and a PCP. Now all patients walking into your office have data you could be pre-screened and you can cut your office size and overhead significantly. Since you are an owner or member in the IPA, you receive payment for your patients care at the Patient Care Center and potential profits at the end of the year.
Is this science fiction or future fact? The doorways to change are open wide. With or without you the paradigm of healthcare will shift. Why not join us and help make it happen the way you want it to be?
Dr Joe Ross, President NYIPA