The Value-Driven Eye Care Game
A Player's Survival Guide
by
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We begin our analysis of where eye care is going in the health care reform world with the fact that eye care belongs. We belong! I wonder sometimes, though, if others believe that more than we do. Is there a remnant pre-parity mindset that still says we do not belong or that we are not integral to real health care, which happens in hospitals and physician offices but not in ours? I know we know better than that but what I cannot explain is the pervasive assumption that health care reform is not really going to affect me.
The stroke of a pen made all optometrists Eligible Providers under Medicare. Optometry instantly belonged to the mainstream of health care. State associations and individual providers did not need to take further action, other than to begin claiming the benefits of the AOA’s win. I am sure that many of us who have been around long enough to remember the day still, and will always, remember it as one of the most significant days in the history of optometry.
Health care reform is not like Medicare parity. Even though we now clearly belong and are counted among the Medicare Physicians, when it comes to health care reform, we must help ourselves. On parity day, the AOA did it for you. Now, you must help yourself. So, what does that mean? Health care reform is a new game with new rules. More than a single piece of legislation, it is now about the introduction and implementation of new technologies, new standards and guidelines, new rules and new laws galore. It is a game of connected care and it must be played out practice-by-practice, facility-by-facility, provider-by-provider. The needed adaptations, of course, put you in control of your destiny. You must engage to learn the new game even as you continue playing by some of the old rules. The transition is neither easy nor instantaneous. Fortunately, you are not alone. Your professional associations and groups are there to help. Indeed, the purpose of this guide is to give you a game strategy and, hopefully, simplify your task.
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About the Book
With the establishment of optometry as the primary eye care profession, and significant reforms under way in health care, the opportunity exists now to add value to an independent eye care practice for both the doctor and the patient. The favorable geographic distribution of optometrists in rural and urban locations lends well to the evolving trends of health care in America. Ease of access to care without having to travel long distances lends well to the economics for patients.
The difficulty for the independent practice is the paradigm shift required on several levels: from paper records to electronic; from an optical focus to medical, from individual and episodic care to team-based and coordinated care. Add to this the concomitant increase in the complexity of billing and coding and we have a whole new game on our hands, a survival game. The exact strategy to make this shift adeptly does not exist.
Vision without execution is hallucination. This guide will serve as a basis for applying some organizational sense to the adventure of creating a new medical model for forward-thinking optometric practices.
About the Author
Larry J. Alexander, OD, FAAO, author of the “New Medical Model” chapters is no stranger to the optometry profession. Well known for his authorship of Primary Care of the Posterior Segment, a text used by most schools and colleges of optometry as well as by eye-care practitioners, Dr. Alexander speaks out now on the value-driven eye-care game from an illustrative academic career as a clinical professor of ocular disease at the University of Alabama Birmingham Medical Center School of Optometry. In early 2013, Larry launched Eye Lessons, a website dedicated to providing educational lessons, articles, slides, and white papers for the betterment of optometry and ophthalmology.
Larry lives with his wife, Lynn, near Dallas, Texas.
Alistair L. Jackson, M.Ed, FAAO brings to the optometry profession much-needed insight about health care reform. In his reform-focused chapters, Mr. Jackson shares the wisdom of his many years of researching, writing, and speaking to doctors about electronic health records, certified EHR technology, and the implications of health care reform for independent eye care. Given his extensive study, writing and expertise on this topic, Alistair has attained FAAO status in the Special Category for non-clinician contributors. In early 2013, Alistair launched Eye Care Advice, a consultancy dedicated to curating health care reform for forward-thinking eye doctors.
Alistair lives with his wife, Ruth, near Vancouver, Canada.