Back in the day, Vision Plan was developed as a methodology for selling the services of its owner, the profession of optometry. Vision Plan acted as optometry’s agent; effectively owned and controlled by the profession itself. Vision Plan represented an efficient institutional marketing effort; a sophisticated marketing tool utilized by otherwise unsophisticated marketers. Reimbursements were reasonable and the fee reductions associated represented an effective use of marketing monies. For the typical optometrist ten years ago, such discounting represented around 11% of revenue. This expense is a sales cost, as Vision Plan is “paid” this money in exchange for patients. And an 11% cost of sales was a reasonable investment to put “butts in seats.”
As the marketplace has evolved, four interesting and dramatic phenomena have developed.
Greed: First, the premium dollars paid to Vision Plan by employers grew to billions of dollars. Vision Plan employees saw this pot of gold. So, Vision Plan figured out how to change their structure to disengage control from the profession that launched it and place that control in the hands of Vision Plan itself. Today, Vision Plan clearly operates, not for the benefit of its Providers and former “owners,” but for the sole benefit of Vision Plan. So says the Supreme Court.
Back to billion$; these monies are invested in a variety of ways to create additional earnings for Vision Plan. Companies were purchased. Beautiful buildings were acquired. Technology was developed. Employees were paid exceptionally well with benefits that earned Vision Plan an outstanding reputation; one of the best in the nation. All this occurred while Provider reimbursements languished at 1980’s rates. It’s important to note that Warren Buffett created his amazing investment vehicle with insurance premiums. Vision Plan is no dummy.
As the monies flowed, it’s clear that greed became the driving force for Vision Plan. And why not? With Vision Plan now controlling almost 1 of every 6 of optometry’s potential patients, and as much as 8 of every 10 in some markets, it’s easy to understand how Vision Plan might think that they invented the ultimate economic engine. And because Providers are addicted to more and more patients, maintaining the “we’re here for you” mantra was easy. Today, some 25,000 optometrist “addicts” are, sadly, hooked on the drug of the Vision Plan “dealer.”
Naiveté: Now, as time marched on, there evolved a second force. I’ll term this force “marketing naiveté.” With Vision Plan supposedly delivering so many patients, Providers didn’t have to develop or execute marketing programs like other businesses. They could sit back and rely upon the volume delivered by Vision Plan to fill their books. “Who cares whether the patient is profitable, we’ll make it up on volume,” they said.
Just as the addict is hooked to the dealer, Providers got hooked on Vision Plan.
But soon others saw the power of Vision Plan and wanted in on the opportunity. More dealers arrived on the scene; driving the value of the drug (patients) downward. And soon, others offered the drug in a different way, at even deeper discounts. Big box retailers got in the game. Internet delivery arrived. Vision Plan had competition.
Just as the dealer does to the junkie, Vision Plan began taking more and more from the Providers.
“We have to compete,” they said, “we’re working hard for you so that those big bad competitors don’t take away your patients.”
“We’ll sell our plan to individuals.”
“We’ll install retail locations within large employer sites.”
“We’ll set up internet delivery.”
“We’re on your side,” Vision Plan said.
The Coffin Door: Vision Plan has an incredible asset, the names and contact information of tens of millions of Provider’s patients. Vision Plan has frames; they own the largest U.S. distributor. They own the labs to produce lenses. And, as a result of acquisition (using premium dollars and the margins squeezed from Provider’s pockets through under-cost reimbursements), Vision Plan purchased the software firm that is used by thousands of its Providers. So, Vision Plan has all the eyewear and technology links it needs to service its many millions of patients. Ever concerned about Provider’s ability to compete, Vision Plan “helped” Providers by implementing an on-line purchasing site. This was done so that Providers could compete in the cruel modern marketplace. Is it coincidence that Vision Plan retired its old guard leadership and promoted its former Chief Technology Officer to the CEO position?
Starting to get the picture?
The Critical Battle: Finally, Vision Plan is now openly fighting with the very Profession that birthed it. Where do Provider’s services belong in the new health care environment? Should vision care be a carve-out, available only through Vision Plan and its “benevolent” competitors? Or should vision care be part of main-stream health care just like all other physician services? Optometrists aren’t real doctors, are they? Just 10 years ago, the typical Provider “junkie” was paying about 11% of sales to the “dealer” to feed their patient volume “habit.” Today, that number is closer to 35% and climbing. And as reimbursements continue to languish at 1980 levels, it’s ironic that the need for ever-increasing investments to deliver the very best level of care is increasing. New technology is needed. Better trained staff is critical. More modern and enjoyable facilities are required to compete. With costs continuing to rise and reimbursements effectively declining, Vision Plan’s Providers are finding themselves in a financial squeeze.
What a horrible situation for Vision Plan!
Or is it?
Simply stated, one can conclude that Vision Plan is very happy to have Providers earning less and needing more. Isn’t that what fuels further reliance on the “dealer?” Provider has an apparent insatiable appetite for more patients because without more patients Provider can’t maintain past income levels. Provider is hooked on Vision Plan.
But the Vision Plan “drug” has become too expensive. The “dealer” is almost completely controlling the “junkie.” And next, the “dealer” will dramatically reduce their need for the “junkie” by selling their products directly to the consumer via their internet-based initiative. Of course, they’ll throw a crumb to the junkie in the form of dispensing fees. This will serve to keep the Junkie hooked on the Vision Plan “drug.”
The fox long ago entered the henhouse.
What’s sad about this situation is that progressive optometrists can do so much better than life within vision plans. Sure, it takes some confidence; a conscientious approach to service; and attention to the details of marketing and merchandising. But there are many former Providers who have proven that there’s life after Vision Plan.
“I dis-enrolled with VSP one year ago. My gross charges are actually down a bit this year – by almost exactly my amount of VSP charges last year. My net, however, is almost exactly the same as last year. So I am working less and making the same money. Correlation does not mean causation, but it is a heck of a coincidence, isn’t
it?
Would I like to have my net up? Sure – who wouldn’t? But it hasn’t gone down. And I have much more room to grow my practice this way.” Dr. Don Furman, Iowa
It’s clear that vision care belongs within main stream healthcare. And I’m confident that once enough individual optometrists take action with a “we’re sick and tired and not going to take it anymore” attitude, vision plans will either change their ways or be relegated to compete with all those other discount retailers that exist in every market; and against which optometrists have very successfully learned to compete. Certainly, the consumer doesn’t need vision plans to acquire affordable eyecare.
It’s clear that vision plans are “brand destroyers.” If the only reason that our industry can sell our services and products is with a deep discount, we have over-valued our own product/service. Personally, I don’t think this is the case…but most Providers and Vision Plan acts like it is.
It’s time to take back your brand.
It’s time to stop being afraid of life without Vision Plans.
It’s time to recognize that Vision Plans have outlived their usefulness to the Providers who birthed them.
It’s time to get on a 12 step program and wean from this very expensive addiction.
Author’s Note: My use of the term “junkie” is intended to make a point and not meant with any disrespect for the profession that I have served for almost forty years. I have written extensively about vision plans (for more about Vision Plans, simply click on the “VSP and Managed Care” category at the top right corner of this page) and I thank my readers for passing on my blog. I encourage you to read the immediate prior post which details activities of importance at the state level. I encourage every optometrist to get involved with the AOA at your state and federal level to support the battle for your future involvement in mainstream healthcare.
Painful to read..but o so true.
Watching and working with VSP(CVS) for 42 years was, for the 1st 30 anyway, somewhat enjoyable, the last 12 however, have been progressively more scary, something like the federal budget, out of control with a future hard to imagine!
Thanks for the visual (and the wakeup call)
I am the OD that was quoted in your post. As you accurately passed on, my gross was down the first year after VSP dis-enrollment, but my net was nearly the same.
The following year, my gross was up 11% and my net up 15%. through the first quarter of my current fiscal year, I am up another 5% gross and 7% net. The exam slots previously taken by VSP patients are steadily being filled with patients who are just as nice, and more profitable.
Thank you , Al, for shining a light in this “dark corner” of our profession. I hope enough private practice ODs see this light in time to keep optometry from slipping further into the abyss.
-Don Furman OD
I read your new blog post and thought it was great. Unfortunately it will be falling on deaf ears as too many of the addicts are not smart enough to know when to say no. It is sad where optometry has gone and where healthcare in general is going. Although optometry has made greart strides they don’t get that they have invested hundreds of thousands of dollars in themselves and then they are too scared to charge for their knowledge. Plumbers and electricians are smarter. Even the idiot that came out to appraise our corvettes today charges more than an OD….and all he ended up doing was looking in a book.
Greed:
So you say that Vision Plans are out for the sole benefit of the managed care company themselves. Looking at your love for the big two, how about you clarify a bit on them? Where do all those profits go when the plan is EyeMed? To support Lux. And their investors. How about VSP? Who are their shareholders? Are you also saying they should pay their employees less than a fair wage or lower the bar on work environments? WOW! What type of company would they be with your running the ship. Not likely a place that excels or values their people obviously.
I love all your dozens of vague references to VSP, so let?s just call them out shall we? Looking at reimbursements Al, what would envision happening should they bring their languished reimbursements from the 80?s to a dollar value their doctors would like to see? How do you think EyeMed would position a $90-$125 reimbursement fee when they go to market? What impacts would you see on their new found weapon of the ECP?s own creation would be on said private practice docs? Do you think the private practice OD would benefit or would perhaps EyeMed capture a HUGE share of market to funnel even more patients to the Luxottia Engines located in their vast retail locations? Love to hear your thoughts. I?ll share mine but please, share yours. Please include your thoughts on the new private branded products you speak of too. Love to hear how you feel they are not good for the marketplace VSP Serves.
Naivet?:
So you?re saying that VSP is driving patients to the practices but said practices have no way of making profitable dollars on those patients? WOW! How familiar are you with all the means for VSP Providers to make money utilizing the additional products and programs made available to them? Last I checked there are thousands of dollars just waiting to be had. It is however up to the practice to actually sell inside their dispensaries?.you know, that retail space just outside the lane that they should also be selling within. Their fine not selling I suppose, but then looking for a handout in return is just a little greedy don?t you think?
So where do you see VSP taking from the providers they support? Is supplying a program that offers individuals who do not have access to a company based managed care plan a bad thing for the individual? How is helping people see better wrong? What comes first in your word of vision care Al, the money to the doctor or wellness for a patient? Surely you can?t be suggesting VSP support the wealth of a doctor over the well being of a child or hourly wage worker? Are you really saying that for a managed care company to provide a benefit to a patient in the form of a discount is horrible? Really? You?re saying that a poor wage working in the US of A shouldn?t be offered a discount plan and instead pay that money to their ECP? THAT right there sounds greedy to me. ?Sorry Mr. Smith, you?re kids education, lunch money and shoes don?t mean anything to me, I?m the doctor, you?re not and the money belongs in my pocket because I?m better than you.? Nice!
Has VSP removed anything form their bag of support for their panel providers? What have you seen them take away? Have they not gone to their providers for input and support for the onsite clinics the employers created?
The Coffin Door:
The FUD Factor is strong with this one. Why is it Al that VSP Bought Marchon? Does it have anything to do with needing to compete with Lux and their large frame income powering the engine of their machines taking patients from private ECPs? Are you saying that VSP should just let all the components needed to drive their support of the ECP panel docs dry up and that said private docs would be just fine? Really? How are all the other areas of the world where VSP is not located doing in terms of the health and well being of independent ECPs? In those same countries, please point out how the retail competition and online providers driven by Lux are doing? Hmmmm something tells me there?s a reason why you don?t mention all that. Could it be that where there?s no VSP there?s a overwhelmingly strong presences of the real enemies of private practice? I?m sure that?s all just a coincidence too.
Starting to get the picture yourself?
The Critical Battle:
So Al, are you a supporter of ObamaCare? Really? You and the AOA would rather roll the dice, remove managed care as we know it today and roll all those patients over to a Gov?t sponsored plan that in turn will make the doctors rich right?
How do medical doctors feel about all the changes coming? What makes you think ECP?s are going to benefit over what they have today when ALL those other doctors out there are proving that Obama?s plan is the beginning of the end for many and hell for those that stay? I look forward to hearing your thoughts. I?ve not yet seen any proof the Gov?t can help us. I can?t wait to see your thoughts and would love to be a part of your discussions with MD?s all over when trying to garner some of their insight on how mainstream Obama Care will benefit us all.
You?re right, better technology is needed. So is it wrong that VSP Supports docs in that fight? Do the plans today not reflect that? Do the products they now offer not support better technology for a lower price and stronger reimbursement for ECP?s? I wonder where all that money is coming from to support these improvements that support ECP?s? Again, looking forward to a role play with you at VEE if you?re there on how raising fees will benefit an ECP?.or will it? There we can also talk about all the products and services offered to VSP Docs that drive drive differentiation from Lux and provide profit to them vs Essilor and others. There we can talk about how the money VSP Makes is reinvested into these products and programs. We can talk about all the aspects of the industry. Love to see that happen.
I?d love to continue our discussion and your FUD factor on VSP going direct. Has that happened yet? Share with us the facts, I can?t wait. In fact, I?d love to even see the hearsay that?s out there. Any leads on VSP doing just that?you know, selling direct and pocketing the money without reimbursing a doctor? Can?t wait to hear about it.
Yep, we can absolutely share the success of doctors who are not on the panel. Because you know, I don?t recall where VSP Made it mandatory nor ever said your life would absolutely be better by serving as a provider. You spin your words as if both were true. Well, maybe, just maybe one day, you?ll put a few quotes up from all the larger practices who?s principles make far more than the Mgt. team at VSP and live in bigger houses and drive much nicer cars all while driving a business that is substantially less in revenue than those same managers. Maybe just someday.
To actually see that you believe vision care belongs exposed to the same pain that mainstream healthcare is going to be under ObamaCare is very scary. Certainly doctors are just anxiously awaiting for the reform to happen so they can be oh-so rich. Certainly consumers would yield better discounts at the mercy of generous doctors who even today scream of higher wages and private pay dollars.
It would be interesting to see a group of say 2-3 years worth of students enjoying the life of struggling to compete with retail shops as they set up their private pay only offices right across the street. We all know how mom and pop businesses are just thriving today don?t we? I?m sure the casualties of those that don?t make it would be high, but hey, it would be worth it for those that do survive wouldn?t it? Good luck with all that.
Funny how many of us addicts are out there making a very good living from Managed Care. I’m sure if the graduating classes of 2012 were to all forgo joining a VSP Panel, they would all be just fine on their own.
I mean how could they not be? We all know tons of independent plumbers and electricians and those idiots appraising our fancy sports cars are all making more than manged care docs right? They are the real millionaires next door aren’t they? Yeah…right…….
You’re right Donald, there is certainly room for a few of the 28k plus docs on the VSP Panel to remove themselves. It really is an overcrowded market. One that I think would be best served by making the joining of a managed care plan more difficult and perhaps even limited.
Perhaps that’s the answer? Why grow the pie of panel docs fighting over patients when many of them can just go serve the private pay market and in turn leave those patients for the panel docs with empty chairs.
You’re right, I don’t know any fellow OD’s with empty slots on their schedules. We are all busting at the seems with private pay patients filling up slots VSP clients are hoping to get in.
Usually when I’m scared it’s because I lack control or knowledge about something. If you’re truly worried about the future of your practice and are a panel doc with VSP, perhaps you should meet with them to discuss the market and insure that you understand how to managed your VSP business so that profits are maximized. Get a good look at where your practice sits in relation to all those around you and even nationwide.
Wow! Al must really hit a nerve when he posts about VSP.
Not only did you feel it necessary to respond to each comment, but you also added a 1500 word manifesto on the virtues of VSP.
I am curious – are you just a VSP panel doc, or do you have a larger role in the company?
This blog is open to the world, as it should be. That said, anyone can read it. Which is good. However, should a Vision Plan corporate manager (who apparently gets paid far less than an OD) or doctor sympathizer infiltrate the nest, I think we would all be best served by a degree of anonymity; like Poster Anonymous. I have had personal experience with one of the Vision Plans and their local provider meetings. A doctor at the meeting questioned the Vision Plan corporate representative and local doctor sympathizer about a new change which was for the good of some entity other than the doctors. It was a reimbursement or service cut to keep “competitive.” The doctor asked about this race to the bottom and was passionate in his or her presentation. Within 2 weeks his or her office was presented with a FULL Vision Plan audit. This punitive measure wasted further time and resources for this practice. Just remember, the Emperor is not as forgiving as Al.
I guess since Vision Plan is non-profit, they expect the doctors to be the same. By the way, according to the 2008 #53 Best Places to Work ranking (http://money.cnn.com/magazines/fortune/bestcompanies/2008/snapshots/53.html), the most common salaried position at Vision Plan paid just over $101,000. (Which was up $10k per year over the previous 2007 listing.) I don’t remember getting a 10% raise in reimbursements from Vision Plan in 2008. Did I miss something? Not bad for a non-profit. It is a shame that the greedy doctors cannot be so altruistic.
I am a principle in a nice size VSP Practice and also hold a law degree. I think that might clarify my point by point response eh? 🙂
So Luke, you’re suggesting VSP Audited a doctor’s practice simply for questing them on a program in place? The FUD Factor is high with you as well it seems.
In terms of exam reimbursements, I would also post the question to you about how you might think EyeMed would respond when marketing to clients if VSP were to raise fees significantly? Do you not think that getting what you wish for might actually hurt?
I mean, if I’m an HR Director aka client and I find out that one plan pays docs significantly more and also costs me as the client more, then in turn find out a larger percentage of docs are on both panels, doesn’t it make sense that I would go the cheaper route? So in essence, as a panel doc for VSP, you’re not likely going to see that higher reimbursement anyway. You’ll see the lower one from EyeMed….that is when they aren’t directing their clients to retail.
So, No,
1. Yes I am. I work in the practice that was audited. [I have worked in a number of practices that have had Vision Plan audits, so I have some experience in the matter.] One of the partners at the time raised his/her objections at the meeting. The audit was initiated within2 weeks of that meeting, was more charts and more in depth than any other audit I or any one I have asked has ever seen, and was off cycle for Vision Plan Audits for that office. Regardless of the Vision Plan line, it was a retaliation. This was years ago. They got their wish, I will attend any meeting with Vision Plan, where they know my identity ever again.
2. EyeMed does not pretend to be something it is not. It does not force me to use a particular lab or dictate the specific fees I will collect for materials (then charge back much of those fees to cover the lab bill.) EyeMed does not purport to be the friend of Private Optometry. EyeMed may even send recall notices to my patients to get seen at one of their outlets next year. They may be horrible. But, they don’t pretend to be my best friend either. Call a spade a spade and don’t dress it in sheep’s clothing.
Vision Plan must make business decisions in its best interest. I must accept those, as a provider. They want the most lives they can get, and they want to hold on to lives at any cost. That is OK. It is not OK to tell me that these changes are for my good and in the best interest of my practice. Not getting a lab bill does not offset the lost revenue from not getting mark up on product. EyeMed does not tie my hands there. Suggesting I should do medical eye care at Vision Plan rates, when I should be submitting those claims to a patient’s medical carrier erodes my margins further. EyeMed does NOT make me compromise there. EyeMed does NOT have a form for me to fill out showing the patient how much “the plan” saved them, nor does the form say that, actually, the doctor’s office is really saving them all that money by not getting paid. Anyone in the industry knows that EyeMed is far cheaper than Vision Plan to employers, by a couple dollars per employee per month or more. Somehow, Vision Plan still retains 1 in 6 Americans (see their website) as members. So…
3. Why would an HR director choose Vision Plan? There is obviously some kind of value add. There are many doctors who accept Vision Plan that do not accept EyeMed. The panel is better, that adds value. EyeMed has all sorts of commercial locations with better hours than private offices, yet that does not always add enough value to draw a group away. It is disingenuous for Vision Plan to say that they must cut reimbursements to remain competitive. There are other criteria in the value proposition. Additionally, I take issue with the contention that a plan must price itself out of the market in order to compensate the doctors fairly. I will refer back to my earlier post; no one at Vision Plan is taking a pay cut or loosing their jobs, while I am asked to do far more for much less. I have not gotten a raise from them in a decade, but I have gotten pay cuts. Their staff get 10% increases in a single year! The doctors cannot be left holding the bag every time cuts need to be made. As we hear in politics daily, the pain needs to be shared. I am tired of shouldering the load. I don’t see any way for my office to win in a race to the bottom. My fees are different than Walmart and theirs are different than Costco. I cannot compete on cost with vertically integrated commercial locations, so I don’t.
I believe the intent of Al’s commentary is to place into focus the trends we are experiencing as practitioners. Vision Plan is not the worst offender. It is the biggest offender, but not the worst. However, I think it important to show what the “friend” of private practice is doing to us, as it serves to pull the wool from our eyes and hopefully shows the poorer plans for what they are as well.
We can keep doing what we are doing and hoping for the best, or we can see the world is changing and act accordingly. Reaction has not served us well in the past.
Vison Plan bashing is a great past time, but without action, it gets us nowhere. Towing the line that Vision Plan is a good thing for my practice gets us nowhere just as fast. Each doctor must look at his/her practice and the plans that own him/her. If an office takes everything under the sun, as most of us do, then Vision Plan likely is not the worst in that mix. A more reasoned approach would be to ditch to biggest looser first, then another, and so on, until a sustainable mix can be achieved. As I look at our office, we continue to escalate volume, throughput, COGS, expense, and wear and tear. The only thing not going up is Net. I believe Al; this trend is not sustainable. I want to change MY trajectory, while I still have a choice in the matter.
Respectfully
Of course we can?t banter about your experience with the audit. I can say if there was anything inappropriate about it on either side, I?m trust you or them would have addressed the issues in question. Thus either way, perhaps inconvenient but a part of the business when dealing with insurance companies.
What was the result of the audit? Did you find that VSP was out of line in any way or performed any measures inappropriately? If so what was the follow up action? Just curious.
So you?re saying you?d hold a greater support and regard for EyeMed who supports you less and even competes with you by taking patients simply because they are blatant clear with you about how they do business? Not that I even support the thought that VSP isn?t transparent. I believe they are very clear too.
How is VSP ?pretending? to be your friend? What they offer you as a provider is totally voluntary thus your being a panel doc isn?t something they are forcing you to do. Only in OH and CA do they direct a portion of their work to a specific lab. Otherwise, you can go anywhere. Even in those states, the portion of the work which is the Choice Plan is also voluntary. You can still be a panel doc and not support that plan. So given so many options, why is it that you still feel some hate towards them? It?s a choice you?re making not something they are forcing you to do. Unlike other insurance companies such as Davis, VSP absolutely gives you choices. I look forward to your thoughts.
Overall it seems you don?t fully see the reasons for VSP doing business the way they do. Have you ever sought asking them for clarification as to why? I have and I fully understand why they perform chargebacks. It just plain makes sense.
Your comments about not getting a lab bill don?t quite make sense to me. Consider where you?re at on the food chain. You?re a provider office. The patient comes first, next comes their provider contract lab, then you.
VSP performing chargebacks is first and foremost about supporting their patients and contract labs. It insures the labs their panel docs are using do not have to chase 28,000+ doctors for payment. Because as you know, docs for the most part are horrible businessmen and there are any number of reasons lab bills go unpaid. When that happens, patients (ie. Clients of VSP ) could suffer and be left unhappy. Paying the lab bills for you, not only makes it easier for you but more importantly insures patient services will never be delayed for AP/AR issues. It also insures happy contract labs as VSP pays well and pays promptly. Make sense yet?
So now in terms of materials and where you are limited in charging above and beyond on certain plans (again, it?s not that way on all plans such as Choice), there are still plenty of ways to make money with VSP. If you don?t believe so or think so or aren?t experiencing good results, then I would highly suggest you consult with your practice account manager at VSP. That?s their job and I can assure you, based on your notes thus far, you are likely leaving money on the table and don?t even realize it. Your call completely on whether you do anything about it.
You?re right, EyeMed is cheaper. Why? How? They also have far less service. It?s also very well known by employers and in the industry and when patients go from VSP to EyeMed, they are far less satisfied and they also end up paying more out of their own pocket too. Not only are the plans worse, but they also get sucked into the vacuum of retail chains that pillage their wallets far more than private ECP?s tend to do.
So in the end, I think it?s clear why VSP retains so many and does so well. The patients and clients both are clear that they are willing to support VSP and their superior service. In the end you forget that you are not the client or main focus of VSP, it?s a company and plan driven to service the patient and provide them a value that is greater than all the others. You elect to provide services for that plan knowing all the details up front. Again, the choice and how you choose to practice is all yours. Time to look in the mirror and stop complaining about what it is you feel is being done to you and start asking what it is in terms of your own practice and success is happening because of you. Don?t act like VSP is sticking it to us as panel docs. I and a huge number of others know how to create large amounts of success with their business model. If you have suggestions, please, visit them at their booth at VEE. I?ll likely see you there.
You?re right, there are added values to VSP vs EyeMed. However, I?ll say that the two panels have over 82% overlap, thus if you think you are the others on the panel are the real value any more, I?ll clearly tell you that YOU and those also supporting EyeMed are the ones removing that one time value. Why go VSP when the clients has 82%+ of the same choices AND all that retail offers? If you support both panels, you are killing the value add there.
In terms of your exam reimbursements, so let me get this straight, you clearly don?t see how YOU and the other docs supporting the panel are the ones responsible for low rates then? Let?s play hypothetical shall we?if VSP doubles your exam rates, how do you think EyeMed would respond in the marketplace? Do you not see them clearly attacking that with clients? I know as a client I would absolutely say to heck with supporting VSP that charges me more as it?s in turn very clear why?they are overpaying docs who 82%+ of the time are willing to take far, far less from EyeMed for the same work. That makes no sense. So you might be happy for a few months, but in the end you?ll never see the higher reimbursements because EyeMed will have a field day pillaging clients and in turn sticking you with their low rates.
So then you?re also arguing that VSP with the highest patient and client and quite frankly highest service level to their panel docs pays their people too much? Really? Would you rather they take the low road and pay them squat and NOT have happy people helping you and your staff? Not me, if I want that, I?ll go visit Davis and Spectara. Have you read the articles about Davis lately and their striking staff? Again, how about you focus on business issues and not your emotion when talking about the industry as a whole.
So outside fees on exams, how are you maximizing your materials, labs, and all the other many avenues offered to you by VSP? There?s no ?race to the bottom? as you imply. None at all. You?re not sharing a load or being cut. Where has VSP taken anything from you lately only to give it to others? How are you holding the bag. Please share some details. I?d love to discuss them.
Al and his blog does nothing but spread FUD without providing any facts. I?ve posted and replied with tons of clarity and questions, none of which get any follow up. He spreads rumors without facts and stirs the pot but disappears when the dust settles. When was the last time he brought forth conversations he?s had with VSP? Has he engaged them for clarity or their input? Let?s see if he visits with them at VEE and posts some facts. Won?t happen. He focuses on the rallying practices that are upset and fuels fire vs. finds solutions. He promotes his own cause and leverages it against VSP primarily because they won?t fight back against his annoyances. In the end they take the high road as in reality the squeaky wheels will always be, but the vast majority do quite well and that?s where they focus.
Sounds like your beef is with managed care overall and to varying degrees with all the companies. Don?t know what to tell you other than it?s not 1965 and it?s hear to stay. There are plenty of practices doing well without it, but for me, I have multiple locations with over 9,000 claims for VSP per year alone and I won?t trade that for anything. You trajectory is all yours to do with as you can. No argument there. Good luck to you.
why do i even bother?
cleinman appeares to have no clue as to the economics of a large vsp dominated practice, and the aoa is gleefully throwing that practice mode under the bus as well. what a one-two punch for the future of optometry.
Does the aoa want to rid the profession of the crude vulgarity (no matter how profitable) of dealing with glasses and contacts? Why not get rid of refracting while we are at it as well? Would they be happier if we were located between the soap aisle and the pharmacy at safeway, prescribing adolescent punctal plugs after exhaustive special testing?
i hope the aoa members wake up to the profound and harmful changes put in place by the leaders. and as for cleinman, how pathetic does a practice have to be for it to be seen as a savior??