Monthly Archives: December 2014

The State Of The Union – Jan 2015

nyipa LOG0 New One SMALL VERSIONA Bright Exciting Future Full Of Opportunity Greets Optometry In 2015, Thanks To Our Growing Unity!

Quality Vision Care Becomes More Profitable – This year, more than ever in the history of Optometry,  there is profitability returning to optometric practices as the bullies on the block are meeting their matches.  As EyeMed, VSP, Davis and others drive profits down to the dirt,  IPAs across America are reversing that picture and finding themselves able to buy needed technology and spend time caring for patients rather than rushing them out the door.  Cutting out the middleman in eyecare has no small effect! Medical doctors have been proving this for years.

Eye wear Quality, Profitability And Patient Appreciated Value Grow Together!  – Thanks to the national support of IECP and its nationwide IPA owners, we have access to quality eye wear that so outstrip big labs like Essilor that it boggles the mind!  The least expensive progressive lens from VCD Labs, is FAR better than the best from Essilor at a vcd labs logomere fraction of the cost! For many ODs in NY,  VCD Labs has added amazing profitability even though we are just beginning to use the services. Patients can switch from ANY progressive lens to the Acuity Progressive and adapt instantly.  I tried this lens as soon as the lab came on line.  What truly AMAZED me was not the unbelievable low price but the fact that I could see at night better than I have in 10 years!  For 10 years I accepted poor night vision thinking my Varilux lenses were the best. I had bought into the Essilor Hype!  No more!  I have never had a better progressive lens in my life and all my brother and sister IPA members are now talking about how amazing  it is. There are even more specialized progressives if you need and we had the blue blocking coatings way before Essilor! Take the plunge now if you are an eligible NYIPA doctor who has not.  Remember either you direct your future or someone else (vsp, eyemed davis) will!

Optometry and Ophthalmology Work Together For Mutual Success! –  All accross America groups of ODs and OMDs are working on mutual opportunity creation.  Our NYIPA  ACO Chairman,  Dr Ami Ranani, has been traveling to meetings in NY that are aimed at achieving medical care goals that cannot be ignored by the new health care entities, ObamaCare has spawned.  In the South Eastern USA, near Tennessee OMDs and ODs have been creating potential alliances, that if democratically structured, will benefit all.  I am traveling to Jacksonville Fla, this first week in January to learn more about these possibilities.  Meanwhile  here on LI,  Dr Eric Donnenfeld has created a model for OD / OMD cooperation that may become one we help spread accross NY State.  With ODs,  OMDs and PCPs working together, we can easily cut the costs of catastrophic medical illness to ACOs and other entities.  In this manner we secure a place for optometry in the changing medical landscape.

As the Chinese say, when change comes it should be redefined as Challenge. The word challenge should be looked upon as opportunity for in the dirt of change are the seeds of opportunity.  NEVER in the history of eye care, have eye doctors and leadership come together so forcefully to harvest the sees of opportunity.  If some of you colleagues have yet to join the NYIPA,  remind them of what they are not supporting and what they are missing!

We at the NYIPA,  Thank Reid Nelson, the visionary founder of Vision Care Direct,  for his constant support and the over 5,000  ODs nationwide, who have joined in ownership and support of IECP,  our national organization, leading optometry’s march to prosperity and excellence.

Dr Joe Ross,  NYIPA President.


Reality Check – The Competition You Are Supporting For Your Own Destruction!

The competition sets the price of your services, whether medical or optical,  it is the consequence of the “free” market place.  The competition in medical plans is hard to find but fierce!  It is hidden because it is more complex to describe and those selling it don’t want you to see it.  In the “preventive routine vision care” world the same is true but easier to uncover.

Here is some of it for you to see,  A VSP plan built by years of the financial trust and confidence private practitioner put in VSP’s statement of its founding principles,  “support for private practice” (now better known as lies and deception offered to sucker Ods).  See VSPs terms and who they are promoting (not you for sure!). 

Here are a few graphics from its highlights page:   (can’t find the words “private practitioners?”  It is there! It is the 90% who are providing long hours but being passed off as Walmart and Cosco  stores!  This is NO error or accident.

VSP's Preferred Partners

I Hate Vision Plans


The following was written by Dr. Don Railsback who practiced optometry in Neodesha, Kansas (population 2,900). Currently, he manages Vision Care Direct sales full-time in Kansas.
“Put a vision plan in at Cobalt Boats! Are you crazy?” This was my thinking
process several years ago as I was forced to consider such a ridiculous idea. After all,
Cobalt was the largest employer in town. They had almost 900 people working there and
in my mind I was seeing a large majority of them and their families. The thought of
seeing all those patients at a discount gave me chills. Times were tough enough with new
competition in the form of the big box retailer, Wal-Mart opening just thirteen miles
away and a large optometric group buying and expanding a practice in another
neighboring community. “Why should I sell a plan that would make me take a discount
on patients I already had in my practice?” I kept asking myself.
Yes, it was true that I had been selling Vision Care Direct all over the state. And
yes, I had been telling doctors and staff people that VCD was different, that you could
actually make a decent margin with VCD and that it would tie patients to their practices
that might be going to Wal-Mart or Lenscrafters. But, this was my practice, my town, and
things were different in my situation. Sound familiar? It should because every day I run
into doctors who believe that their situation, their community, their patient base is
different somehow. That adding a vision plan, any vision plan is like joining forces with
Satan himself. I was that guy….
Then my conscience got the best of me. I had stalled long enough and the fact that
I was out selling VCD all over the place (except my own back yard) finally got to me. In
November of 2005, I went out to Cobalt, presented the plan, and much to my chagrin,
they bought it. Their effective date was January 1, 2006 and for a about a week after the
sign up I worried about what affect it was going to have on my practice. Then something
interesting started happening. The phones began to ring. Patient after patient starting
calling in to schedule appointments in January! The phones didn’t stop ringing over the
next month until our office had NO appointments available in January, February or
March! We had to reorganize our schedule and actually extend our days to add more
exam slots. This was a pleasant surprise in some ways, but my deeply ingrained
optometric doubt gene, kept me awake a few nights, wondering if these patients were
going to cost me more than I took in. I had spent my entire career believing that vision
plans, any vision plan, were bad for optometry. Those long held beliefs weren’t easy to
let go of.
What eventually changed my mind were the numbers. I had always been a
numbers guy and we tracked every facet of our practice very closely. I could see very
profit growthpositive numbers coming in very early. Gross sales were up, but more importantly the net was up! Not just the net, but the percentage of net to gross! “How could this be possible?” I asked. I dove into the numbers and found several interesting changes in my practice. For the three month period of January, February and March I saw more NEW
patients in the practice than the previous TWELVE months. Not only that, we saw more RETURNING patients in those three months than any quarter since we started tracking it.

We define returning patients as those that had left the practice to try somewhere else and
then came back to us. The vast majority of these patients had been to a WALMART
because they thought it would save them money. Many of them, I didn’t even know I had
lost, because they hadn’t admitted it on recall contacts. When we asked them why they
had come back, 100% said because the vision plan helped them afford to get the kind of
care they wanted anyway. Very few were happy with their Walmart experience but were
too embarrassed to come back on their own. Many of them had been long term patients
who I had taken care of since I started in practice, and I would have never believed they
would leave me, let alone go to WALMART!
Another interesting statistic was that the average patient expenditure was up.
More people were electing to add AR, high index, transition and upgrade their frame.
VCD was helping them save on their frame and lens purchase so they were able to
upgrade and still have a palatable bill when they were through. Patients were happier
because they could now afford to take my recommendation for these lens treatments.
They left feeling like they were following the doctors’ orders and weren’t ignoring my
I almost couldn’t believe that adding a vision plan to a company that didn’t
previously have one could do so much for my practice. Average per-patient sales were
up. Gross was up. Net was up. We saw more new patients per month, than ever. The
schedule was full and patients were actually happy with their vision plan and so was I.
More patients were seeing private practice docs and fewer were going to big box
retailers. The other doctors in my area were also seeing more Cobalt employees and were
seeing similar results. I learned that I wasn’t really seeing as many Cobalt employees as
I thought I was. The “conventional wisdom” was wrong.
It was working so well that I decided to try to present it to other industries in town
and sold it to two more companies and the city. I made a critical error with one
manufacturing plant, however. I decided not to try and sell it to that plant because they
had an indemnity plan that allowed me to get full fee from their employees. I thought I
should leave that one alone since their plan was so good. The next thing I knew, the
company changed plans to save money. That plan was set up so that selling additional
lens treatments actually increased the percentage write-off and forced me to take between
a 40% to 60% discount on jobs with additional treatments or upgraded frames. This
national plan also would force me use one of their labs and has a claims filing system that
is a nightmare for the staff. I wasn’t on that plan and the numbers just didn’t make sense,
so I did lose some of those patients. If I would have been smarter and presented the plan
to them early, VCD would have had a good shot of landing that one also.
Don’t get me wrong. I still don’t believe that every vision plan is good for
optometry or your practice. Vision Care Direct works because it is designed to be a WIN
for everyone. VCD member patients save money on their basic frame and lens package,
doctors can balance bill for add-ons and upgrades, and employers can save money by
offering the plan on a voluntary basis and running it through their pretax 125 plan. VCD
doesn’t have a profit motive for selling vision plans so can reimburse doctors at a higher
rate than other plans. VCD is doctor owned and actually wants those enrolled to use their
benefit! These are important differences between VCD and other plans.
magnifyingDoctors really do need to take a close look at the plans they are considering.
Taking a poor plan can actually drive down fees across the board. When doctors sign up or every plan on the market it confuses companies looking at the plans and they end up
choosing the lowest cost plan, not the one that may be best for their employees. VCD has resources that can help doctors evaluate plans, look at chair costs and understand the maze of plans that are on the market. Private practice optometry has to start taking care of private practice optometry. Every doctor needs to look at each plan based on not just the impact on their own practice but also on their profession.

It’s ok to hate vision plans. We’d probably all be better off it they didn’t exist, but
they do. The challenge is to find and support the plans that support doctors and build the
profession. Decent fees are important to patient care. If doctors aren’t profitable they
can’t invest in equipment, staff, training, education, and facilities. Eventually, the level of
patient care will suffer. It’s time for us to let go of “conventional wisdom” and embrace a
plan that can actually help us practice the way we want to, take care of patients the way
we want to, and protect our profession from big box retailers and the pirate vision plans
we all hate.

A Grass Roots Perspective Of IPA Opportunity

I just met a young lady who is director or HR for a 100 employee company in Danbury CT.  It is a 15 minute highway drive from my office but in the neighboring state of CT as I am in NY on the CT border.  If an IPA sells a plan to this company, whose IPA should fund the plan?

I emailed Jeff Palmer, the CT IPA president, and asked,  “would you like me to contact this lady and if we sell a plan, share it with NY?”   He said sure!   Later he suggested it be a NY Plan that CT be invited to participate in as we would set most of the

Fundingparameters. I suggested that I would contact the HR Lady and arrange a meeting but then it occurred to me, NY would not want to fund this plan as 95% of the patients (which could end up being 3 – 4 hundred, if it went well) would be in CT!  Ami Ranani and I are  the only NY docs that might benefit.
What’s the point of selling this plan?  Is there a value in IPA cooperation? I see the opportunity for a Tri-state co-op of IPAs as exciting as winning the Powerball!  When you start a rocket off the pad, 70% of the fuel is used in just overcoming inertia and getting it moving off the pad, the other 30% gets it into space and to its target.  VCD Labs is a great idea but the need of getting VCD Labs  launched and used by all IPA docs might be better served by using its profits and “financial capital’  (fuel)  to launch IPAs that USE VCD Labs to launch themselves!  This is what the Space Shuttle does with its fuel tank first stage;  the shuttle depends upon the power of its first stage to get off the Earth and then uses its rockets for its special mission.  VCD Labs will never be “Required” of IPA docs because we set the policy and we in essence will own the lab as it grows and if it grows.   However recognizing the economic realities of our times and wanting to duplicate the financial success of EyeMed and VSP,  ALL VCD IPAs must seriously align themselves with VCD Labs to get off the ground and own a piece of  Earth’s Space.
Without staking our claim and defining out  lab financial “Turf” now, at this opportune moment,  we may forever lose an opportunity for independence!  Vertical integration IS PROVEN!   It makes EyeMed and VSP market juggernauts that appear unstoppable until you realize the power of the VCD co-operative marketing concept that cuts out the middleman profits and makes VCD unstoppable, if we can all see the opportunities of VCD labs. vcd labs logo Yes, we can outdo EyeMed if we are willing to work together and stop squabbling over some small intrusions on our perceived freedom of choice!   If our country’s forefathers had forbade any power to our Federal Government,  America never would have been born!  If they did it and it gave us freedom, why should we not follow in the very same footsteps to economic freedom?  Davis beats you to death with financial clubs because they are confident that you are afraid to give up one ounce of independence to work as a team.  You would rather be beaten by Davis and bitch about it at society meetings!  Are they right?
If owning and using your own lab (as EyeMed does)  is such a great idea are we, as VCD,  unstoppable?   Well VCD Labs is a small part pfo globalof  PFO Global which sets up labs accross the world.  PFO Global is going to become an IPO  very soon!  (You will likely see the same from Vision Source, whose franchise fee is now 2.65% to make it really fattened up and ready for an IPO slaughter in my best guess).  If  we want to stay in this game, we need to be part of the ownership of PFO Global  or find an alternative. Both are options.  The best and easiest is to be a part Owner of PFO Global and keep control of the superb technology we now have our hands on. The lens quality is unbeatable and the prices phenomenal.
How can a new IPA do this, sell plans and fund plans?  For many this is the $64,000 question.  I think there is a way to do this and it involves a change of plan and vision by IPAs and VCD Labs.  Each IPA should be trying to sell its plans;  but, when it is neonatal,  it is not going to sell much or be able to fund much of anything.  If the  Neonatal Launch Plans were re-designed around a Required VCD Labs Based Plan – an option to launch the IPA …. not a required process for every plan we sell. Then VCD Labs could fund any plan its ‘contracting IPA”  sold by  taking the contract’s financial value to the bank with almost no risk, as I explained over the phone to Reid Nelson and Don Railsback.  VCD Labs could also invest in its/our  future by possibly even helping to sell plans.
You light a lighter with a spark, not by hiding it in a dark room.  To many IPA doctors the true importance and value of VCD Labs is invisible.  Docs get their feathers ruffled when you talk about a required lab for a given plan!   But keep your feathers down,  NO IPA would be required to use VCD Labs, it would just be a launch option that becomes less needed as an IPA albert-einsteingrew.  But,  who would stop using something that you  liked,  made you money and you had an investment in, via IECP?  Do you throw your widowed mom out the door when you get your first job?  In essence,  I believe, VCD Labs could help launch IPAs and IPAs can help launch VCD LABS.
As for CT and NY,  there would no longer be an issue in selling the plan I have envisioned. All border docs would be equally motivated even though they are in financially independent IPAs.
Not enough doctors using VCD Labs?  Perhaps it needs to be more than a lab, just as IECP is more than a VSP.
———-     here below is an interesting view from the lab industry newsletter. ——–
Issue Date: OLP November 2014


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Recently, I took my 13-year-old daughter to a book signing by a 21-year-old vlogger (video blogger) who’s written a book called “The Pointless Book.” It’s an innovative way to make money. These minor celebrities are actually YouTube partners and get paid by YouTube for creating their own “original” videos, and uploading them on a regular basis.This experience got me thinking about how the ways of doing business have changed so dramatically. During these leaner times, labs need to become more creative, just like these celebrities have.

Managed Vision Care (MVC) is now a big part of our industry with some type of MVC coverage being used to buy 60% of eyeglasses. Perhaps labs could team up with vision care plans to offer patients more choices in terms of eyewear, lens types, and lens options?Two major vision care plans have integrated with their retail stores: EyeMed Vision Care/Luxottica and Davis Vision/Visionworks of America. Will we soon see Walmart stores get into this space?

I asked Richard Sanchez, managing partner at Visibility Management, LLC, who moderated an Optical Lab Division panel at VEW what he thought. “I think labs should look to partner with vision care plans,” he answers. “Some vision care plans have gone with an optical lab exclusively, while some (Avesis) are partnering with labs in various regions. The trend is that managed vision care plans do want to partner with labs and are looking for partners that can meet their needs in terms of quality data management, eligibility, claims files, and pricing.”

Eventually, he says, there will be some MVC plans that acquire a lab or vice versa. For an in-depth look at the panel discussion, see “Managed Care and Money.” An independent lab, therefore, should explore its options.

Carol Gilhawley is Editor-in-Chief of Optical Lab Products and can be reached at

Dr Joseph Ross, NYIPA