June 17, 2015
Jim Greenwood, president and CEO of Vision Source, describes the ongoing transition of health care from fee-for-service toward fee-for-value. He outlines how optometrists are ideally positioned to provide quality care in innovative ways in the new era of health care reform.
Moving From Fee-for-Service to Fee-for-Value
Connecting to Narrowed Networks
Jim Greenwood, president and CEO of Vision Source, says the current health care system is more of a “sick care system,” in which the highest payments go toward specialists caring for illnesses rather than toward primary care providers who help to maintain wellness.
That is rapidly changing, he points out, as the current fee-for-service model is being replaced by a fee-for-value model. A watershed moment in this transition came in January 2015, when Health and Human Services announced specific goals for moving Medicare reimbursements into the fee-for-value model.
In addition, employer-based, self-funded plans are driving health care toward narrowed networks that provide quality care at affordable costs.
“These plans are looking for innovative extensions to primary care,” Greenwood explains, “and optometrists are ideally positioned to make a difference.”
Every day, an optometric practice sees 2-5 patients with unidentified health risks,” Greenwood points out. Optometrists can connect these patients with primary care providers to better manage their disease states, improve compliance, and ultimately, lower costs. In addition, there are millions of cases of undiagnosed diabetics and pre-diabetics for which optometrists can provide treatment efficiently and affordably.
Jim Greenwood cites three action points for optometrists who want to position their practices to connect with narrowed networks that are looking to provide comprehensive care efficiently and economically–and with a high level of patient satisfaction.
Report results. Consistently report post-exam results to physicians who provide primary care to your patients. This will further your collaborative care relationship.
Measure quality. Measure the level of patient satisfaction with the care you provide, and be prepared to offer scores to narrowed networks that will request them. Show that you act upon the feedback you receive to improve patient satisfaction.
Build relationships with primary care clinicians. A single primary care practice may have within its patient base hundreds of diabetics in need of care that an optometrist can provide. Position yourself to receive those referrals.
Alliances like Vision Source can help optometrists to gain entrance to narrowed networks by acting as one organization whose members provide consistently high standards and care, Greenwood underscores. Health care networks are looking to approve the group of ODs collectively as providers of care, rather than approving ODs individually.
Independent ODs can continue to be independent and retain their practices in this new environment while being part of a group with common goals, Greenwood believes. “You can be independent yet part of a group that learns together, invests in equipment together and functions consistently in communicating with other health care providers and in measuring patient satisfaction with the care provided,” he says.
DOWNLOAD THE VISION SOURCE REPORT: Navigation Guide to Health Care Reform for Independent Optometrists.
Jim Greenwood, is president and CEO of Vision Source, the network of independent optometrist with nearly 4,000 members in about 3,100 locations. To contact him:firstname.lastname@example.org