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Last Word

Down to Business

By: ERINN MORGAN
Eyecare Business July 1, 2005

WHAT'S NEW - Last Word
Down To Business
by Erinn Morgan

This month, ECPs bring their opinions to the table on the subject of managed care's impact on profits, for better and for worse.
If you have a story to share, or would like to see a subject covered, please E-mail us at editor@eyecarebusiness.com or send a fax to 215-643-1705

The impact depends on how you manage your practice. To make managed care profitable, increase the number of patient encounters per day.

We have adapted by delegating some tests to trained staff. Patient load must increase to counteract the reduction in reimbursement.

— Donovan "Don" Crouch, OD, Vision Care Associates,
Storm Lake, Iowa

Last fall, we had a fourth-grader in for his annual eye exam. His parents had a managed care plan which covers photochromic lenses at no charge to his parents. After hearing the benefits of the lenses, they decided to get them.

About a week later, two kids in his class—who didn't have vision coverage—came in for photochromics because they thought the lenses were so cool. We gained two new private pay sales due to this managed care patient. Who says third-party plans are so bad?

— Michael Oase, optician, Tempe Eyecare Associates, Tempe, Ariz.

 

When you're busy seeing private pay patients, you're not happy to see managed care patients. In slower times, you are happy to see them to help make ends meet.

It does cover some of your expenses, sometimes. But, does it improve profits? I'd have to say no.

— Robert W. Smalling, OD, Warren, Ark.

a matter of facts
Managed care is on the move. The national enrollment in HMOs has grown from just under 20 million in 1985 to covering more than 68.8 million individuals today. That formidable number has many ECPs asking "Where have all the private pay patients gone?"

Following are a few pertinent tidbits from the U.S. Census Bureau about the population and health insurance to help describe the overall picture.

  • The number of people with health insurance coverage increased by 1 million in 2003, to 243.3 million (84.4 percent of the population).
  • An estimated 15.6 percent of the population (45 million people) were without health insurance coverage in 2003, a count that's up from 15.2 percent and 43.6 million people in 2002. 
  • The percentage of those covered by employment-based health insurance declined. The number fell from 61.3 percent in 2002 to 60.4 percent in 2003.
  • The percentage of people covered by government health insurance programs, including Medicare and Medicaid, increased from 25.7 percent in 2002 to 26.6 percent in 2003.

 

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