Healthcare Reform and Optometry

The debate over healthcare reform remains front and center.  Vision Monday recently ran an op-ed authored by the VSP board chair and incoming board chair about how healthcare reform could impact optometry.  Give it a read below and leave us a comment sharing your take on the issue.

Op-Ed: Is Your Practice at Risk?

Here’s What You Need to Know About How Healthcare Reform Will Impact Your Practice and the Optometric Profession

I’m sure we would all agree that access to eyecare should be an important consideration when working toward healthcare reform. The questions are, what is the best way to accomplish reform and how will it impact not only your practice but the overall optometric profession?

Amazingly, the current health reform legislation calls for major medical plans to deliver children’s eye exams. As a result, families with vision plans will face the choice of either maintaining two separate vision plans or moving all of their coverage to what will/could be an eye examination-only medical plan. This means all of your business from specialized eyecare plans could be at risk.

The current legislation could ultimately lower the number of individuals getting regular preventive eyecare. Data shows that when exams are integrated into medical benefits, there is a significant drop in utilization. In fact, this results in patients seeing their eye doctor less than half as frequently as they do when their care is delivered through specialized eyecare plans. When coverage is limited to an examination only, patients are four times less likely to visit their eye doctors.

What do you think will happen to your eyewear patients? An eyecare benefit that includes both exam and material coverage encourages patients to obtain their eyewear from you, while the examination only program included in the current legislation could encourage patients to take their prescriptions elsewhere.

The amount of medical eyecare you are currently providing could quickly go away. Since we are part of the optometric profession, we know most medical patients are the result of an eye exam, not a referral from an MD. A specialized eyecare plan like VSP often includes medical coverage as part of the eyecare benefit. At present, 37 million of VSP’s 55 million members (68% of the member population) have a benefit that integrates both vision and medical eyecare and often allows you to treat to the full scope of your license. VSP also has 9 million members enrolled in programs where medical data is exchanged directly with the members’ health plan. With this many members at risk, our opportunity to provide medical care as doctors is also at risk.

Finally, if currently proposed legislation passes, you will face the challenge of attempting to join health plans that may have historically prevented optometrists from joining their networks. Even when optometrists are allowed to join a health plan’s network or bill major medical for services, we are likely to be reimbursed at a lower rate than other professionals.

If you find this troubling, we strongly encourage you to contact your local congressional leader and voice your concern. You can find your Senator’s contact information at

James L. Short, O.D., Board Chairman of VSP, and Timothy C. Jankowski, O.D., F.A.A.O., Incoming Board Chairman of VSP

2 Replies to “Healthcare Reform and Optometry”

  1. Wouldn’t it also be fair to say that if more people have access to routine eye exams then doctors would see an increase in exam revenue?

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