Optometrists Must Be Proactive to Be Included in ACOs

The market for ECPs will change,” Edward Barnwell, president/founder, KDD Health Solutions, told Vision Monday. (Essilor hired KDD to write The Eye Care Professional and Emerging Models in the Reform of Healthcare.) “Those willing to embrace change and initiate organizational competencies will be successful. There are very few independent community pharmacists,” he said as an analogy. “If the independent ECP does not adopt some of these strategies, they will be subject to risk.”

“Someone is not going to do this for you; you have to do this for yourself,” added EyeCare Advice’s Jackson. Unlike legislation favoring optometrists, often promulgated by national and regional optometric associations, joining an ACO will be left up to each and every optometrist. “Looking back at Medicare parity legislation, everything changed at the stroke of a pen, but health reform is not like that,” continued Jackson. “If you are not learning where you fit in the rubric of ACOs, you are going to be left out.”

“Get active or there will be ramifications,” added Jerry Sude, chairman/co-founder, OD Excellence. “The majority of these entities don’t include vision yet. Optometry is its own worst enemy because optometrists are reluctant for fear of rejection or thinking that ophthalmology has already opened the door. Neither is true. If you wait, you are setting yourself up to not be involved.”

Jackson agreed that ACOs need optometry, but optometrists are not being proactive: “If you don’t take action, it’s not that nothing will happen. Everything is changing, and if you are not doing something to change what you are doing then the survival of your business will come into question. If optometrists don’t think that they belong, then why would anyone else, but the reality is that other doctors are interested in optometrists. They acknowledge that optometrists know more about the eye, so they probably need an OD on the panel.”

“After being denied hospital privileges for years, I contacted the hospital-based ACO administration,” said Harvey Richman OD, FAAO, FCOVD, a New Jersey-based optometrist who is now part of two ACOs and looking to join two more. “By demonstrating optometry’s participation in a board certification process, the ACO was actually aggressive in pursuing several optometric practices in our state.”

While being invited to join ACOs is a rarity for optometrists, it does happen. In the case of OneCare Vermont, optometrists were invited to join (see sidebar, page 42). “We reached out to everybody in our existing Vermont Managed Care PHO network, which included optometry,” said Norman Ward, MD, about the OneCare Vermont ACO he helps administrate. “Of 61 optometrists and 35 practices, less than half, 26 optometrists and 13 practices, signed up.”

Whether proactive or reactive, there is still time. “A lot of optometrists feel they’re getting into the game too late,” said the AOA Third Party Center’s Pridgen, “but it’s not too late.” ■