The single biggest challenge we have faced, are facing and will face it getting doctors to understand market realities and change. How About you? Can you define ACO? If not, your blind! Do you understand that you can compete with EyeMed? If not your blind!
ACO KNOWLEDGE – A SIGN OF BLINDNESS: At our last presentation to a group of doctors in NYC, I asked these well seasoned ODs if anyone could explain an ACO…. no one could! Yet, ACOs , which may end your practice financially and your future dreams, have been around for several years and are growing rapidly!
Not being aware of the dangers or potential opportunities of ACOs can cost you all your years of hard work in building your practice. This is what I call being blind!
Who’s in charge of ACOs — hospitals, doctors or insurers?
ACOs can include hospitals, specialists, post-acute providers and even private companies like Walgreens. The only must-have element are primary care physicians, who serve as the linchpin of the program. More than half of the current Medicare ACOs are actually run by physicians and don’t include a hospital partner.
In private ACOs, insurers can also play a role, though they aren’t in charge of medical care. Some regions of the country, including parts of California, already had large multi-specialty physician groups which became ACOs on their own by networking with neighboring hospitals. “A lot of health care organizations are going to dust off the existing structures they had in place” says Kelly Devers, a senior fellow at the Urban Institute.
In other regions, large hospital systems are scrambling to buy up physician practices with the goal of becoming ACOs that directly employ the majority of their providers. Because hospitals usually have access to capital, they may have an easier time than doctors in financing the initial investment, for instance to create the electronic record system necessary to track patients.
Some of the largest health insurers in the country, including Humana, United Healthcare and Cigna, are forming their own ACOs for the private market. Insurers say they are essential to the success of an ACO because they track and collect the data on patients that allow systems to evaluate patient care and report on the results.
Here is a basic education about ACOs from Kaiser Health News…. learn more, you need to!
CUTTING LAB COSTS TO BE COMPETITIVE: We have had several discussions about price in regard to redos and complimentary pairs with the top management of VCD Labs, the lab owned jointly by all the IPA’s who are part of our nationwide team. Their comment to me is that we can have an outstanding price, which we have, (like our retail competitors have on their materials) or we can have complimentary pairs, free redos, expensive sales reps and big brand names as we see from the outdated big lab distribution channel labs like Essilor, Zeiss, Hoya etc On top of what they give away to doctors, they have a strong mandate to make money for their shareholders. But we can’t have both low price and loads of free stuff. Not much is free in life and certainly not in business.
WHY VCD LABS: Our objective was to get on equal ground with Walmart, Costco, Luxotica retail, Vision Works – etc. They don’t have expensive lab reps calling on their stores, comp pairs, and our shareholders, in our case are our doctors, you get your shareholder dividend right up front with low prices and better VCD reimbursements. VCDlabs is priced so that you can both compete and make a heck of lot more money. We hope that by explaining to doctors the realities of the market, they will realize they are paying for the free stuff and understand that its not free.
A NEW MINDSET: We are recommending that you calculate the redo rate into your pricing, add more than what you would normally do to cover redo’s, its what Essilor, Zeiss, etc do when they charge you the prices they do.
ENTERING AN RX INTO YOUR EMR AND THEN ON SCREEN AT VCD: We understand the double entry pain, we definitely want to fix that, but it takes money and time, we are working on solutions, we have stacked up priorities. Getting outstanding product at rockin’ low prices has been a priority.
CHANGE IS HARD: We constantly face the challenges of bucking the old method of doing business. Our competitors innovated and were rewarded for doing business differently with a 60% market share. I know change is hard.
DUES YOU PAY TO VSP, EYEMED ETC: While I am on the soap box, the same line of logic and understanding applies to vision plans. Doctors love the higher reimbursements of VCD, but they hate paying dues. Doctors need to understand the cost of marketing comes from somewhere. VSP, EyeMed, etc take it off the top, THEN they reimburse doctors. Every time a doctors provides care, they are paying for marketing and vision plan shareholders in the form of lower reimbursements. Nothing is free!