Monthly Archives: February 2014

Why Do Some ODs Hesitate To Join Us?

Todd B.  of Pennsylvania asked on FaceBook:   “Financial disclosure? Getting a little bit jaded at posts of this nature (about the NYIPA)  and who’s behind them and who stands to profit from them.”

We responded:  Your voice echos the fears and concerns that are keeping Optometry in the age of enslavement! I was once at a Sunday Non-Denominational religious gathering. The speaker asked me why the Jews had to wander for 40 years in the desert after leaving Egypt. I said, I did not really know but I thought that it might have been because those who had Adopted Slave Mentality as a way of life needed to die off before others could see the opportunity of Freedom! (lets not argue this story..this is about ODs not the bible).slavery IN CHAINS

I would argue that ODs are the same today!  They are so used to be controlled by VSP, EyeMud, Daffy’s Vision PLan, Etc. that they fear doing what their predecessors did and take some real risk as a true independent business owner! They comment at their imagined concerns without even doing any research because those with slave mentality have no hope, no dreams and no inspiration! They just plod on because their hearts are still beating not because they are excited about life and opportunity.

I have yet to figure out how to reach people whose dreams have died, people who imagine an investment of $800.00 with your own colleagues in a co-operative venture and some effort, would be of concern when VSP and EyeMud, are sucking the financial life out of their practices like vampires!

CHANGE takes vision! CHANGE causes fear and confusion but AT LEAST YOU FEEL ALIVE! Benjamin Franklin said, “sadly, most men live till the age of 21 and are buried at 65.” This is what he was talking about! He knew he was risking his life when the helped create the Declaration Of Independence but feared being the walking dead much more!  If you live in another state and  you are not a NY Resident, Check out the NYIPA anyway  and get one started in Pa. or wherever you live!  Take back your life and help your colleagues do the same. As they say, “teamwork makes the dream work!” Get a dream and fight of it!  

(See our National Network too, https://www.visioncaredirect.com/ and dream big!)

Optometric Unity – Power In An ACO Era!

ACOs ,  PCMHs what are they and how do they affect your future as a doctor or aco scared doctor!patient?  Both terms refer to organizations of health care providers  who agree to provide health care services to a population for a fixed fee with the new innovation of cost and service  monitoring provided by EMR and other tools. The gatekeeper MD model, that failed to control cost in the Clinton era, is again being reincranated as a new financial savior. In addition, physician’s fees may be adjusted by their “performance ratings”  as determined by the ACO.  It is a drifting away from fee for service to fee for “outcomes”  based upon a standard set by the ACO and often defined as “evidence based”  medical care.  If it sounds like and HMO, with capitated fees, and more regulation of what a doctor may and may not do as result of bureaucratic oversight,  well that might not be too far off.  

What is the cost issue? Health care in America did  cost nearly $2.7 trillion in 2010—$9,000 per person—a $200 billion increase over 2011. $763 billion of this is for Medicare and Medicaid alone, which is over eight times the federal spending for education. Medicare Dollars IN handand Medicaid costs have now squeezed out Social Security and defense as the number one expenditure in the federal budget, consuming 21 percent of President Obama’s 2011 suggested outlay of $3.5 trillion….. don’t know about you but to me these numbers are meaningless other than when you tell me they cost  me $9,000 / year!

On the other hand there are opportunities as the system is ripe for innovation and the birth of creative organizations.  What are the issues that need to be addressed for cost containment?  Many are difficult areas upon which to tread, such as the last years of life.  Dr. Jonathan Bergman of the University of California in Los Angeles, an author of a report on the costs of these last years medical “heroric” efforts had this to share:  “We end up Futurespending about a third of our overall health care resources in the last year of life,” Bergman said. “It represents a huge avenue for improvement.” To deal with these issues, ACOs  may  need to trade quality of end of  life  for minuscule possibilities of extended life. But lets skip this important but lengthy issue (in this article)  for the one we may have more control over without huge public, religious and emotional debate.   Real  Accountable Care! Not just a new name for HMO’s.

Real Accountable Care  should mean not just that a physician is accountable but that the whole  system is accountable.   Consider  “Insurance companies” as needing reform as much as healthcare.  Consider Bill McGuire,  CEO of UHC,  who in 2006 left with a bonus of 1.6 BILLION DOLLARS (stock options).  We might assume someone paid for this in terms of lost benefits to patients.  Again not an issue you or I will change but in the same vein what Accountabilityabout the patients taking responsibility,  being accountable?   Smokers should pay higher premiums as should those who are obese and those who make no effort to be physically fit.  Patient’s who, when repeatedly are educated by their doctors about needed diet and lifestyle changes, and make no effort should also be responsible.  A system that does not reward efforts with lower fees, is bound to fail!

As optometrists we have a unique opportunity to help meet the Holistic  needs of the new health care paradigm.  Most of us are already taking BPs, body weight, asking about alcohol and smoking.  This is being more holistic.  In addition we also have the opportunity of monitoring general health via retina imaging.   Retina imaging will give the PCP feedback as to the success of his/her efforts in patient health management.  PCPS Retina Bigwho do so are rated better  receive higher reimbursements. 

How can this save an ACO or PCMH money  and why is it needed?   It has been reported that good teamwork between a PCP and an Optometrist monitoring patient systemic health via retina imaging can save an ACO  $6,000 / patient.  What is needed to make this paradigm even more powerful  is not just communication between doctors  but Accountable patients too!  

For example, the cooperative effort between PCPs and Optometrists at diagnosing early arteriolarsclerosis and treating it is a big step but patients cannot expect the system to give them a quick fix in the form of a pill!   This mirage of past medicine, and pharmaceutical slight of hand,  must evaporate with the sunshine of the new ACO day.   In my own practice I have stressed retina imaging and patient education as a focus of our medical care.  Over 9 years since we began offering holistic retina screenings  we have literally saved hundreds of lives by preventing strokes, heart attacks and diabetic blindness.  Many of you have done so too!  The most propounding difficulty however is patient cooperation.  How many of you have said to a patient, you need to cut your carbs significantly to avoid diabetes only to be told “Doc, I am Italian, to give up pasta, pizza and good Italian bread would be worse then death! Besides Doc,  I am bullet proof!  I take Mevacor.”    Even the pharmaceutical TV ads for the drugs say “with diet, exercise and  Meva###,  many patients show less……..blah, blah, blah… ”   In an accountable care age,  with projection of health care causing national bankruptcy, everyone must be accountable.  But how?   

More and more of us are providing patients with literature about diet, exercise, weight loss, and sources for counselling, especially when it comes to smoking.  Yet, patients are not held responsible other than by early death.   One thing we have found very helpful is getting a patient to read a health newsletter that is free!   If you think about it,  all our decisions are based on the media and social relationships we are part of,  our “data Road sign to  education and futureincome stream and programming”  in computer lingo.  If a patient adds a new  information source that reaches them regularly, they frequently will modify their behavior to some extent.  I do not have the time to write a newsletter of this proportion but I “plug” them into one I like from and MD.  Pick yours and recommend it!  I refer patients to Mercola.com. It has been life changing for many of them.  I also have my patient education literature published on the Internet and I send them literature  as an email link to my free booklet. This too has worked well.  Being able to download and read my materials on their smartphone or other device has been life changing.  One patient lost 100 lbs in one year after we talked and he read my literature.  His stage II hardening of the arteries totally VANISHED in just one year!  He also went to the gym 4 days a week too!  A few words not to be missed here is “after we talked.”  Reasonable fees are needed to give doctors of all types time to talk with their patients.  It has a lot more impact coming from a doctor than a tech who has memorized a script.

It would be nice if we could reach everyone this effectively but it is not so.  There is a need for a financial responsibility taken not just by the doctor, the hospitals and the ACOs but by the patients too.   Patients must and can be monitored for compliance by our EMR records just as PCPS may be monitored by successful outcome scores.  Those that do not make an effort and show no progress,  must bear the burden of their choices.

As the new health care paradigm evolves,  we must seek a voice in ACOs and PCMHs.  We will have a voice if we are BIG ENOUGH and UNITED ENOUGH to matter.  This is the goal of Teamworkthe NYIPA.  Quality patient outcomes through inclusion in the new health care paradigm by the Power and Size of a Unified New York State Optometry!

Join the NYIPA, make your voice heard! Make a difference by working with your colleagues to do something you never dreamed possible, save thousands of lives though a team effort!

WHAT SUCCESS FEELS LIKE!

IMAGINE: What if you could earn an extra $50.00 to a $100.00 on every pair of glasses you sold? What if a local hospital organization invited a group of doctors you belonged to, to provide the medical eyecare for its network of patients? What if you could really TreadMill Screenshot from 2014-01-28 10:29:05understand your chair time cost and have enough choice of plans your own organization was selling to drop plans that do not pay you well enough?   Would it get you off the treadmill of running faster and faster for less and less fees?

DON’T IMAGINE, it is reality taking shape as teams of independent volunteer OD’s all make-money-onlineacross America are uniting into state IPAs that are coops owned by the state’s OD’s and no one else. Even better they are working with other OD’s across America that have created this success, such as the IPA’s in Kansas and nearby states.
THE PHENOMENAL SIGN OF SUCCESS is the recent beginning of the refusal of OD internet media to allow these IPA’s a voice on their web sites! They might just be concerned about losing advertising dollars from EyeMed, VSP, VS, and others that pay their way and see organized private practice optometry as a power they fear! What Could Be More Exciting! It means that Private Practice OD’s are succeeding!

HOW TO SHARE IN OPPORTUNITY: Go to  https://www.visioncaredirect.com/ and learn more about how to join or start an IPA in your state!

QUESTIONS? Feel free to write to me from the NYIPA website. Go to the about tab and use our online email tool to write me, Dr Joseph Ross, NYIPA President!

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Why Eye Care Is Essential In Cost Control!

Integrating eye care with medical benefits can help improve the management of many diseases, leading to better health outcomes and lower costs, according to a new white paper by UnitedHealthcare.Retina Big

The white paper, Integrating Eye Care With Disease Management: It’s Not Just About Diabetes Anymore, demonstrates how eye care providers can play a key role in identifying people with various diseases and then partnering with primary care physicians to deliver holistic, patient-centered care. Based on an extensive analysis of prevalence, detectability and impact, the paper concluded that eye care practitioners can help detect and monitor many chronic conditions – in addition to diabetes – including several unexpected ones.

Besides diabetes, eye care providers can help detect and monitor multiple sclerosis, tumors, Crohn’s disease and sickle cell anemia. For some conditions, such as sickle cell anemia, the value of eye care is in monitoring the disease. For others, such as Crohn’s disease, the impact is greatest when a comprehensive eye exam helps care providers identify the condition earlier and track ocular complications caused by medications used during treatment. Eye care providers can also help monitor disease severity and progression for many conditions, including high cholesterol, rheumatoid arthritis and juvenile rheumatoid arthritis, Graves disease, AIDS and lupus.

“The eyes are the window into a person’s overall health, and eye care practitioners can play a critical role in preventing and managing chronic conditions,” said Linda Chous, O.D., chief eye care officer, UnitedHealthcare Specialty Benefits. “When eye care practitioners share information about diseases with patients and other care providers, it can lead to better information, better decisions and better health outcomes.”

Many employers are starting to embrace this approach. UnitedHealthcare’s Bridge2Health program provides integrated vision and medical benefits that support patients and health care professionals with information, decisions and outcomes.  Future

(Editors Notes:) In the ACO model this leads to better reimbursements for doctors too, as they are often based on pay for performance models.   It is also why EyeMed wants private OD’s on their panel…..at least for a short time!    See our short video The State Of Health Care, to see a perspective of the future, in just 5 minutes!  

 

Read the entire UHC story here…..