- Anthem Health fined for violations in Maine
- AOA, affiliates take on VBM lobby’s attacks on optometry
- Surveys say patient and doctor concerns about health industry middlemen on the rise
- Town hall draws hundreds as AOA and affiliate advocacy earns back millions
- AOA to update profession on health, vision plan advocacy efforts
- VSP warned on campus misinformation, efforts to divide the profession
- Talk of the townhall: Doctors view plan abuses as threat to doctor-patient relationship and quality care
- Don’t miss how AOA and affiliates are fighting against vision plan abuses
- AOA, state affiliate tracking California lawsuit alleging VSP monopolistic practices
- When getting paid will cost you
- Optometry’s wins over abusive vision plans stacking up
- AOA survey finds discrimination by health and vision plans
- Aetna Prior Authorization
- Medicare Advantage claim denials
- AOA, affiliates prompt changes to MAC claims processing
- Payer issues hot topic at AOA on Capitol Hill
- AOA and state associations target plan abuses
- Be a better negotiator on payer issues
- Anthem stops unilateral downcoding of eye codes
- Congress probes vision plan policies
- vision plan reimbursment
- aoa challenges VSP plan
- AOA fights back against discriminatory vision plans
- SGRC-TPC-Conference
- AOA affiliates assemble advocates to address evolving payer issues
- NAVCP Patients doctors come out ahead in states vision plan fights
- VSP spells doom gloom
- AOA never stronger takes issue with VSP practices
- Health plans changing tone vision plans not so much
- SGR TPC 2017 Conference
- Conference delivers vital advocacy tools knowledge
- Vision plan advocacy What doctors need to know
- State third party conference offers advocacy essentials
- AOA backed DOC Access Act targets health and vision plan abuses
- AOA secures important wins in historic SGR reform legislation
- AOA continues fight for permanent SGR fix advises members to hold claims
- House advances SGR fix AOA secures key role for ODs in sweeping Medicare changes
- AOA and Congress work toward permanent SGR fix
What defines the value of care we provide?
June 1, 2023
Health and vision plans have not adapted and grown with the care we deliver but hold back optometry’s momentum.
Tag(s): Advocacy, Third Party
Excerpted from page 5 of the May/June 2023 edition of AOA Focus
Welcome to the new normal.
Somehow, I’m not sure that I’ve seen much change when it comes to the care we provide—at least not much that is positive. Nationally, we have all been subjected to unprecedented changes at all levels of life and practice.
I know how much more challenging providing care has become. I also recognize the importance of adapting to change; it is a necessity in health care. We mobilized, evolved and even expanded our care over the past 20 plus years as our scope, standards of care, and technology have evolved. We persevered through one of the greatest crises in modern history and today we lead the way in the delivery of eye care to our communities.
So why not celebrate? Think about what it costs your office to care for each patient. That cost has increased dramatically, even if you didn’t purchase technology or do a remodel. Our staff and commodities have greatly risen, especially in the past few years. Again, we should all be proud that we provide high-quality, high-value care. But the boat anchor holding us back has not changed (at least for the positive) over that same 20 years.
What concerns me—and the AOA—is what hasn’t changed over the years.
Health and vision plans are stuck in a 1990s pay scale. They have not adapted and grown with the care we deliver but found a pathway to increase their profits and, in turn, hold back optometry’s momentum. In short, they publicly reinforce the quality care we deliver while devaluing our profession by continuing to follow an outdated model for how doctors are compensated for the essential care we provide.
We need to adapt and define our value differently. The plans publicly share that vision is priceless and is directly related to valuable care that contributes to overall quality of life. The perceived true value of the vision care we deliver is to their company bottom line. At some point the vison plan market will hit a breaking point. There is only so much more that can be done when there are continuing diminishing returns.
The AOA understands this dynamic, and we are taking action each day to address the disparity and move toward an equitable system where the value of our care is recognized, not just verbally but through realistic and fair care coverage and valuation policies. We are committed to evolving the health and vision plans’ valuation of our essential and expanding role in health care.
This is a daily focus for the AOA Board of Trustees, our almost 275 volunteer doctors, affiliates and our staff. You can find out more information about what we are doing every day in the AOA’s Health and Vision Plan Action Report, featured in AOA’s First Look, as well as at aoa.org. Even better, join us in Washington, D.C., in fighting for the value of our care at Optometry’s Meeting® and AOA on Capitol Hill. We have a track record for driving change and we will continue that forward momentum.