What Kind of Eye Health and Vision Care Do You Have?
The last few years have seen major changes in the healthcare and industries and public policy surrounding healthcare in general. These changes have impacted the field of optometry, and have forged a new operational reality for doctors of optometry. In this new paradigm of healthcare, doctors of optometry are working to provide better patient outcomes and lower costs, while expanding and broadening the scope and reach of their practice.
The healthcare reform that is sweeping through all sectors of the healthcare industry emphasizes improved quality alongside cost savings. The AOA Third Party Center initiative is helping to implement this new paradigm, while educating payers, purchasers, and patients throughout the country on the myriad benefits of integrating eye health and vision care in core healthcare benefit packages.
Understanding the impact that good eye health has on vision is helping to forge a new relationship between eye health and vision care services by linking vision care to overall patient health outcomes.
Trends in Health Care Related to Vision Care
The Affordable Care Act, or ACA, has provided doctors of optometry and the AOA with a multitude of challenges that need to be addressed to insure that quality eye health and vision care is available to all. Doctors of optometry are a key component to quality eye care services for patients throughout the evolving U.S. healthcare system.
An example of the challenges and opportunities inherent in this shift in the healthcare system are the inclusion of the pediatric optometric essential health benefit, and the variability of interpretations from state to state of this benefit.
Other trends that are presenting challenges and opportunities for optometrists include the elimination of adult routine vision benefits to cover the pediatric benefit, the vertical integration of vision plans, the requirements of vision plan companies for doctor participation in “all plans,” new credentialing requirements for medical plan participation for eye health and vision care, network requirements that may only apply to doctors of optometry, skinny networks, changes in healthcare regulations that may not be clear in how they address eye health and vision care, and many others.
Integrating and Embedding Vision Care
Vision plans have unique strengths in that they deliver discounted materials benefits to providers and patients in the way of eyeglasses and contact lenses. Unfortunately, when these plans aren’t integrated into health plans, it creates challenges and barriers to patients receiving the essential care that they need.
The American Optometric Association is working to advocate for practical solutions through legislation and engagement with emerging value-based care models like accountable care organization, and integrated provider networks. This work will ultimately lead to improved patient outcomes that include lower healthcare costs for eye health and vision care from Optometrists.
As insurers react to these efforts, making cost-saving business decisions, the AOA and its state affiliates are working to ensure that payers are following the laws and regulations implemented to protect doctors of optometry and their patients. These efforts are bolstered through legislation mandating access and nondiscrimination policies such as: general nondiscrimination, freedom of choice, direct access provisions, payment parity, and any willing provider clauses.
The AOA is advocating for inclusion and fairness for optometrists in this new healthcare paradigm, and working to ensure that all doctors of optometry are free to practice to the fullest extent of their licensure, while being reimbursed in the same manner as other health care providers who provide the similar or the same services.
To learn more about current trends in health care and how to best take advantage of expanded scope of practice and payment offered by past and recent changes in law, check in at the AOA website here.
[Photo Via: Wicker Park Eye]