6 developments bring optimism back to health care

Nashville, TN-A recent report from Aegis Health Group listed six developing trends that are spurring increased optimism among healthcare leaders after the uncertainty caused by the Affordable Care Act.

Are these trends applicable to optometry? Bryan Rogoff, OD, MBA, CPHM, who consults on healthcare, business, and clinical practices, weighs in.

1. The innovation movement

According to the Aegis report, the healthcare industry is embracing innovative strategies-including collaborating with researchers, consultants, community partners, and cross-functional teams-to find new ways to approach key challenges. This approach is focused on initiatives that are results driven and promise positive returns on investment.

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“Optometrists should be just as proactive as hospital systems by aligning themselves with the proper consultants and industry partners,” says Dr. Rogoff. “Healthcare affects optometry in a unique way as there is a medical and product component. Accountable care organizations (ACOs) and patient-centered medical homes (PCMHs) systems require all physicians, including optometrists, to have best practices clinically and operationally to eliminate redundancy, increase efficiency, increase quality of care, and maintain patient/customer service.”

2. Population health 2.0

Healthcare providers now recognize that population health is a key element to their success. Experts told Aegis that they expect hospitals and other healthcare leaders to make investments in consumer-directed technologies that put population health programs at the fingertips of local consumers.

Dr. Rogoff says the study of population health is essential to tackle epidemics that affect specific demographics.

“The key associations like the American Optometric Association (AOA), American Academy of Optometry (AAO), and state associations make sure information is available for ODs to transform their practices to tackle public health issues,” he says. 

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Dr. Rogoff says it is important to educate patients and primary-care providers on how they can early detect and manage major health issues through regular eye exams.

3. Next-generation physician-related management

According to the Aegis report, this development is about taking a hospital’s physician engagement to another level with physician data analytics to learn more about precise referral habits and leakage patterns. The goal is to increase service line growth by focusing alignment activities where they would make the most impact.

“Healthcare reform gives ODs a new strategy to introduce themselves to other medical professionals,” says Dr. Rogoff. “Regardless of an OD’s affiliation-private practice, sublease, franchised, employed, etc.-an OD has this unique opportunity to comanage with PCPs, dieticians, etc.

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“Making sure your practice is up-to-date with technology and has best practices will open the door to work with ACOs, value based medicine, and PCMHs,” he says.

4. The age of consumerism

The Aegis report says healthcare providers and hospitals need to be proactive in reaching out to engage consumers and look at the healthcare experience from the patient’s point of view. Healthcare providers need to execute consumer-directed healthcare practices that differentiate them as “providers of choice” in their markets. The report also recommends identifying ways to meet consumers where they are using websites, texts, emails, and even direct mail campaigns, depending on the audience.

Dr. Rogoff says the concept of customer-relations management (CRM) is not new to the ophthalmic industry. Large corporations are spending large amounts of money for CRM to retain patients and consumers.

“For ODs, especially private practice and other types of independent models, CRM should be part of your practice’s operational and marketing strategy,” he says. “Understanding different patient ‘touch points’ and how to maximize the patient experience is essential for retention as there is more choice regarding eye care.”

5. Achieving a productive balance

The healthcare industry is realizing ways to optimize a balance between fee-for-service and pay-for-performance. Some hospitals are becoming health plan sponsors as they adopt direct-to-employer contracting strategies and narrow networks that can offer a “meet in the middle” solution-which is the key to optimizing opportunities with insured populations while establishing the infrastructure necessary to manage patients in an integrated delivery environment, according the report.

It’s no secret that optometry has a unique and complicated system for billing insurance.  

“As hospitals and other physicians deal with health insurance, ODs have to know how to bill managed vision care plans and health insurance and know almost two plans per patient,” says Dr. Rogoff. “As the industry has transformed to bill and code effectively, this fee-for-service is not sustainable in the long term. The Centers for Medicare and Medicaid (CMS) have adopted the Kaiser methods to move towards ACOs, and private insurance companies are seeing the costs savings and beginning to adopt value-based medicine.”

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6. Wellness is the new black

The final trend listed by the Aegis report is wellness. Healthcare systems are benefiting from programs decrease in health-related expenses, higher productivity, lower absenteeism, and workers compensation claims for participants. The systems are these taking these programs to the community by working with employers and other targeted populations. Hospitals and other healthcare systems need to be the trusted authority to which patients turn to for education and support.

Dr. Rogoff says optometry uses a blend of optical, medical, and holistic methods to manage patients.

“This allows ODs to have a competitive advantage over other allied health professionals to discuss with patients regarding wellness, health, and nutrition,” he says. “Wellness and nutrition have become the new buzzwords in health care and patients are becoming aware and educated. Small investments in your practice can transform a simple comprehensive eye exam to much more that concentrates on the eye and other health systems.”