MANAGING MANAGED VISION CARE

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Education is one of the best ways to profit from managed vision care plans, and it often falls to the optical labs to train eyecare professionals to achieve this goal.

Managed vision care is different than most health insurance. You will never wake up in the morning and find out your glasses have cancer or your contact lenses have heart disease. We essentially have a known, much smaller expense that is being paid for over time, much like an installment loan. An eye examination and a pair of high-quality glasses with the latest in digital progressive lens technology and anti-glare treatment may cost $800. If you return every two years for a new exam and glasses, the cost is $400 per year or $33.33 per month. For most Americans, this is quite affordable.

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Young man with eyes pain touching his eyes

Managed vision care plans became popular by reducing the cost of eyewear and eyecare to plan members in two ways – they enticed employers to pay some of the cost, and they require providers to pick up a portion of the cost by demanding lower fees, which means providers’ profitability can suffer. As competition built up among managed vision care plans and employers searched for ways to improve their profitability by lowering their costs, managed vision care plans sought ever-lower reimbursements to eyecare providers in order to reduce costs and increase market share. Due to increasing levels of patients with managed vision care plans and decreasing levels of reimbursement, it became more important to maximize profit opportunities from each patient, affecting all levels of the eyecare provider chain.

PROFITING FROM EDUCATION
For all parts of the eyecare provider chain, education is the best tool we have to increase both profitability and patient satisfaction. Ultimately, it is the patient who needs to be educated, and the best source of that education is the eyecare professional (ECP). However, because many ECPs don’t have the resources and knowledge to train their staff who will then in turn educate their patients, it often falls to you, their trusted laboratory, to play a major role in providing staff training to help the ECP with the process.

3 POINTS FOR ECPS
Here are the three main points that should be covered by any lab training ECPs about how to optimize their patients’ use of managed vision care plans.

MANAGED CAR PLAN ANALOGY
1. It doesn’t matter who is paying the bill, the patient, the managed vision care plan or a combination of both.
We should still prescribe the products and services that fill the patient’s visual needs. This point overarches every other part of the training process. All too often, ECPs inform the patient of what their managed vision care plan will cover and don’t even offer other products regardless of patient need.

Consider this analogy: If someone came out with a managed car plan so that every five years you could buy a new car. The employee would have payroll deductions every pay period, and the employer would also pay a portion of the cost of the premiums. When it’s time to buy a new car, the employee would go to the dealer that was on the panel of providers. Of course, as with a managed care plan, not every car would be covered by the managed car plan, and some options would have to be covered by co-pay.

Perhaps at the local Ford dealership the managed car plan would cover the cost of the basic Ford Focus with a $300 co-pay. However, air conditioning and a sound system would be options that are not covered by the policy. Would covered employees buy the car without these options if they had to pay for them out of pocket? Unlikely. After all, even without managed car plans, don’t most of us drive cars with air conditioning and sound systems paid for out of pocket?

Yet, in the eyecare world, patients frequently don’t even get the photochromic lens option or an anti-reflective (AR) treatment because the ECP assumes the patient may object to having to pay out-of-pocket for the cost of these potentially non-covered add-ons, and they don’t want a patient to think they are “ripping them off.” This leads to patient dissatisfaction with the product long after any perceived benefit of lower cost.

Hint: Teach doctors to prescribe lenses and add-ons. One solution to this continuing problem is to train the doctor to not leave these valuable options to the staff. The doctor should be recommending all lenses and options that meet patients’ visual needs. Because patients believe doctors are taking care of their visual well-being, if doctors don’t recommend a particular product or add-on that is beneficial to their patients’ vision and they hear about them from the optician for the first time, patients will often think that the optician is just trying to make extra money.

Hint: Package all options. Car companies package their options because car buyers like comfort features. Build packages that represent all of your lab’s best options for ECPs to use when fitting their patients with eyewear. For example, offer a package with the lab’s best new products – digital lenses, premium AR, and the thinnest and lightest lens materials with built-in blue light protection.

LEVERAGE WITH LIFESTYLE
2. Discover all of the patient’s visual needs, and offer solutions for each.
Many eyecare practices also need to be trained about understanding the ways in which their patients use their eyes in their daily life and prescribing the appropriate solutions for those needs. The average rate of second pair sales among private practices has hovered between 4% and 6% for a long time although we hear statistics such as 70% of all computer users (nearly everyone these days) suffer from some degree of Computer Vision Syndrome. Why are we not prescribing specialty computer eyewear for 70% of patients? We also know that a huge percentage of car accidents (33% according to some experts) are caused by glare, yet we have very low numbers of practices that prescribe polarized lenses for daytime driving or anti-reflective treatments for nighttime driving.

To improve these numbers, have your laboratory’s I.T. team run polarized lens usage and computer lens usage by account. Target those accounts with low (or no) usage in these categories. This will give you a hit list of practices to approach for training about using their patients’ lifestyles to encourage second pair sales. The best targets are those accounts that buy a lot of lenses (high volume) but sell very few computer or polarized lenses.

It is easy to train ECPs in these categories, encouraging patients toward computer eyewear or polarized lenses. It can be as simple as adding two lines on incoming patient paperwork:

How many hours per day do you work on electronic screens?  _____

How many hours per day are you in a car? _____

To reinforce this in the patient’s mind, the doctor can also repeat these questions in the exam lane, but it’s most important to be sure that these questions are in the initial paperwork because they are more likely to be asked when it is not dependent on someone having to remember.

The doctor can also explain to the patient that polarized lenses block glare and transfer authority to opticians who can use a polarized lens demonstrator to illustrate the benefits of these products to the patient. If the account doesn’t have a demonstrator, your lab can sell them one and possibly offer to offset the cost with coupons for polarized lenses. All of these techniques will help prevent the patient as well as the ECP from limiting the eyewear purchase to just what the managed vision care plan covers.

PUT IT IN THE RX
3. Prescribe solutions.
The patients are seeing the doctor to solve their visual needs, not just to get a refraction, so take that additional step to prescribe those solutions. Don’t let the optician be the first one to bring up the fact that they really should have computer glasses or polarized lenses. That would be like going to your family physician, who diagnoses you with strep throat and then tells you to go to the pharmacist to ask what you should take for the cure. The doctor is the trusted care provider and should use that authority to prescribe the best products for the patient’s visual needs, whether or not they are covered by the managed vision care plan.

MARKETING MANAGED CARE
We all know two things about managed vision care – there are a lot of patients who have these plans, and we get less money for serving them. But they are still profitable, right?  If not, we shouldn’t be doing them, or we need to learn to make them more efficient. If managed vision care represents roughly 75% of your customers’ business, then doesn’t it make sense to build some marketing programs to capture more of that business and also to improve second and third pair sales to those patients? If we can do a great job diagnosing and filling prescriptions for managed vision care patients, then we will do an even better job of gaining the private pay work.

USE INCENTIVES
Some lens manufacturers offer incentives to the labs doing the work for managed vision care plans or to the ECPs caring for the patient base. Talk to your suppliers to see if they have incentives for the managed vision care plans that your lab works with. If they don’t currently have incentives, they may be willing to build a custom program based on growing their business. Suggest growth-based incentives to your suppliers that will work with your laboratory’s sales force, customer service team and ECPs. It is easier to grow everyone’s business from the 75% of patients who have managed vision care plans than the 25% who don’t.

Eric Rollins is a veteran of the optical retail, frame and lab industries. His firm, Rollins Consulting, LLC, consults with the three Os to improve profitability. You can email him at ericrollins@comcast.net.

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