Last night, VSP and the AOA sat down for an informative 90-minute discussion about the inclusion of stand-alone vision plans in the Insurance Exchanges. VSP remains concerned that the AOA has no plans for assuring optometry’s access and parity in healthcare reform.
Watch the video below where Dan Mannen, OD, FAAO, shares his concerns about “putting the fox in charge of the hen house and place our future in the hands of health plans that routinely discriminate against our profession, blocking our access and paying us less for like services.”
If you missed last night’s discussion, you’ll still be able to watch a recording the video here later today: http://vspprovesit.com/healthcare
Curious about the issues? Find out more below (sourced from http://www.vspprovesit.com/healthcare-issues)
If the Exchanges move forward as structured, private practice eye doctors will have to provide care to their patients through health plans.This new structure could lead to a variety of unintended consequences for both patients and their eye doctors.
- Optometrists may be locked out – Health plans have a long history of preventing optometric participation on health plan panels across the country. The Harkin Amendment, which has been touted as providing parity for all healthcare providers, does not guarantee access or parity. So, optometrists will have to rely on health plans to change the way they currently do business and allow them on their panels.
- Optometrists could be forced to accept reimbursement from plans like Davis, Spectera, and CompBenefits – Current law allows these plans to directly participate in the Insurance Exchanges, while disadvantaging stand-alone plans because they are not associated with a health plan. Health plans are likely to turn to these programs when and if they need an optometric network.
- Optometrists could see fewer patients – There are currently 100 million people in the U.S. relying on vision benefits from stand-alone vision plans. Research shows that these individuals with a stand alone benefit get vision care much more frequently than those who have a benefit through a medical plan. As patients transition out of Stand-Alone Plans and into vision/medical bundled programs, doctors are likely to see far less utilization from these patients in the future.
- Optometrists could lose Kaiser patients – Two thirds of Kaiser enrollees also have VSP coverage. In states with high Kaiser penetration, this could gradually disappear as employer groups enter the Exchanges and cannot continue to contract with VSP through those Exchanges.