The following letter is from Tommy Lucas, OD, two time (2011, 2014) Texas’ Optometrist of the Year. Dr. Lucas reiterates what I’ve been saying for the past six years…it’s time to “Declare War” on vision plans. My last post, excerpting from Steinbeck’s Grapes of Wrath, should be read in conjunction with Dr. Lucas’ letter. Both Steinbeck and Dr. Lucas are providing a profound and important message to the profession, as is Superior Vision by their actions.
Thank you, Dr. Lucas, for sharing your thoughts and for your work on behalf of your profession. What action will your colleagues take as a result?
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If you’ve recently received new contract terms from Superior Vision, the title above may be a little surprising to you. Let me explain.
If you’re like me, you’re sick and tired of vision plan companies and the policies they have implemented over the past decade. We all know why these companies are purposely hurting doctors. To compete with one another for employer contracts, vision plans have had to continually underbid each other on the price of the benefit package they sell. When the company sells a plan for less, there is less money to reimburse doctors for services if the company wishes to keep their own profits the same or growing. Vision plans continue to test the floor to see how low they can go to win a contract while reimbursing just enough to hold a panel of doctors together without outright revolt. They would give away a vision plan benefit for free just to feed their other vertically integrated business units if they ever thought doctors were dumb enough to work for free.
Are we dumb enough to work for free?
We’ve reached a tipping point in the eye care industry where the economic forces that are driving vision plans and the economic forces affecting optometry practices are in complete disharmony. Vision plan companies have morphed into self-dealing eye care industry service conglomerates. Selling vision benefit plans is just a single, quasi-regulated entry point for their completely unregulated, vertically integrated business model. As these vision benefit plans slow bleed your practice of profit and strip you of your professional dignity, you may soon decide to forge your own path forward without the contractual demands, administrative burdens and unworkable reimbursements of vision plans. You may have simply had enough and are sincerely frustrated with the way vision plans are treating their doctors. Basically, they’re treating us like idiots.
Are we idiots?
Maybe we were, but we can’t be any longer. As we all cry in our beers about vision plan atrocities against optometrists, I think it is important to remember that we are not without guilt in this modern tragedy. We created the vision plan monster to begin with and then ceded control of it. Later we hoarded contracts from every Tom, Dick and Harry plan that came along that promised to fill our exam chairs and grow our businesses. The consequences of these actions are now coming to bear, and like any bad habit, breaking it will be painful. We need to learn from these mistakes as we move forward.
That brings us to the Superior Vision contract. What a thing of beauty and awe to behold. What’s not surprising are the low reimbursements offered across the board. What is surprising to almost everyone is that Superior Vision has sent you a contract that removes virtually all ability for you to procure, provide and profit from contact lens materials. No company has dared to be so blatant about stealing an entire profit center from your practice until now.
The reason this contract is “good” for optometry is because we need a contract that is so obviously bad that it’s shocking. A contract that provides each of us with the punch in the face we need to wake up to the realities of predatory vision plans. If this contract doesn’t make you start seriously rethinking your practice’s business model, I don’t know what will. You need to adapt your practice to reduce your dependence on vision plan reimbursements, immediately.
Where do we go from here, colleagues? You must decide yourself if this is the particular plan that has pushed you too far, or if it will be the next one, or the one after that. You may even have already accepted a plan or two recently that you really thought was a bridge too far. I can tell you with 100% certainty that each subsequent contract will get worse and worse. Look at the last ten years of actions by vision benefit plan actions if you do not believe me. You need to get lean and mean in your practice and prepare to survive without vision plans. You need to circle your wagon with that of your colleagues by joining the TOA and AOA and contributing to TOPAC and AOAPAC so that we have the resources we need to pivot our profession away from vision plan dependency through legal, legislative, third party advocacy and regulatory mechanisms. The TOA is working hard to shake off the fleas, and I know the AOA is too.
Let’s never lose sight of the single, most powerful trump card we have – people need eye and vision care and they need the optometrists that know how to provide that care. No one needs”vision insurance” in today’s rapidly changing health care marketplace, and the marketplace is figuring that out fast. “Vision insurance” is redundant and unnecessary, but everyone seems to be too afraid to say so. We’re not afraid to say so in Texas. If you are a vision benefit plan company you are welcome to leave our borders immediately. Not only will we survive without you, everyone would be better off once you stop actively trying to insert yourself between us and our patients in every manner conceivable.
Optometry itself isn’t going away because of some bully vision plan companies, but your individual practice may be affected by those bullies in the near future, if it hasn’t been already. If you determine individually that a given vision benefit plan is hurting your practice financially, controlling your professional judgment, insulting your profession or any combination of the above, embrace the suck and make positive, proactive changes to your practice starting today. Envision your practice without vision plans and consider working towards making that vision your new reality. Optometrists cannot and will not let vision plans control the future for optometry.
Tommy Lucas, O.D. – Killeen, Texas
