Dare to be Different: Achieve Independence from Managed Care

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LIVE ONLINE

March 11, 2020 8pm ET / 5pm PT

Would you like to minimize the influence of managed care on your practice, but don't know where to begin?

In this exclusive, new online workshop, Susan Resnick, OD and Viola Kanevsky, OD -- who for the past several decades have both run successful optometric practices free of managed care -- give you concrete, practical advice on how to build your practice by offering products and services to patients without the involvement of 3rd party insurance companies.

The workshop will feature an interactive discussion, including:

* The importance and value of adopting technology and products which clinically differentiate the independent practice and provide avenues of profit protection.

* Real-world applications of these clinical products and techniques in practice, and the economics and business model behind each.

* Marketing tips from clinicians who have successfully made the transition

* Interactive Q&A with attendees

* Written materials (PDF, Word documents) to use as templates to help kick-start the process in your own office.

* Exclusive access to an online community of like-minded clinicians, for further discussion in a secure, private space.

* Discounts from conference sponsors: Art Optical, Euclid, EyeCarePro, Neurolens, SpecialEyes, VTi/NaturalVue


REGISTER & WATCH THE VIDEO ARCHIVE HERE!

If you have any questions, feel free to ask them in this thread!
 

AdminWolf

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I will have more to say about this show in the coming days, but suffice to say it is going to be unlike any webinar we've done before.

This is a how-to guide from two experienced clinicians, they are sharing everything, including the documents and marketing materials they use in their office that allow them to minimize managed care in their own practices (in fact, AFAIK neither takes any sort of managed care at all!)

We want everyone who attends to be able to implement this in their own practice.
 

AdminWolf

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:( I am booked that evening, will this be available after the fact as well?
Yes, the recorded videos and materials will be available on demand afterwards for those who register. We are also setting up a separate sub-forum on ODwire.org just for registrants who want to continue to discuss this topic -- minimizing managed care -- in a very private setting, free from trolling.

Which leads me to the question that people have asked me "why is there a $19 fee for this webinar"?

I mentioned before that this show very different than our usual webinars --

Normally we discuss a technology or single topic, and the goal is to reach as wide an audience as possible. Usually with ODs numbering in the thousands, when all is said and done.

However this show's topic is highly targeted and practical -- we only want people who are motivated to try to implement revenue streams in their practices that don't depend on managed care. Or people who have been seriously thinking about it, but just have no idea where to start.

We want the live portion of the event to also be somewhat interactive. IE, this isn't just a powerpoint talk -- Viola and Sue will be on camera (video, etc), describing what they do, and at several points during the lecture they are going to stop and take questions via text chat.

The speakers are also contributing lots of downloadable content that will be useful for folks who are trying to implement these changes, and again we wanted to make sure that the participants had at least a little 'skin in the game', so we'll get the most engaged audience possible.

So I'm excited for this one, even if the crowd is smaller, I'm hoping that engagement is through the roof.

-- ad
 

Paul Farkas

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The other question "Can I get CE credit for attending". The answer is "No!".

This presentation is not COPE approved because there will be frank discussions about best vendors. Speaking about vendors is prohibited by COPE.
 
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Ken Elder

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One of the problems with seminars like this....... and I realize that there really isn't a good way to get around the problem.......

How much money do these people put in their bank account? That's really the ultimate question here.

Not gross practice revenue. Not net practice revenue. Not percentages of this or that.

How much money did you take out of your business for your personal benefit and enjoyment?


It would be nice if there were a way to know that. It really would put these seminars in context.
 
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AdminWolf

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One of the problems with seminars like this....... and I realize that there really isn't a good way to get around the problem.......

How much money do these people put in their bank account? That's really the ultimate question here.

Not gross practice revenue. Not net practice revenue. Not percentages of this or that.

How much money did you take out of your business for your personal benefit and enjoyment?


It would be nice if there were a way to know that. It really would put these seminars in context.

I'm not sure I follow, Ken.

Your net tells you how much you profited. This is the critical number. How much you choose to retain in the practice (vs. taking a cash distribution) is totally up to you, right?
 
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Ken Elder

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I'm not sure I follow, Ken.

Your net tells you how much you profited. This is the critical number. How much you choose to retain in the practice (vs. taking a cash distribution) is totally up to you, right?

Well.....a practice can net $300,000 and if the owner puts $300,000 back into the practice, that person isn't eating that year.

Obviously, that is an extreme and absurd example.

So the number I'm interested in is "how much money do you pull out of the practice for your personal enjoyment."
 

Paul Farkas

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So the number I'm interested in is "how much money do you pull out of the practice for your personal enjoyment."

More important how you use your practice to enjoy life with pre-tax dollars. What deductions work.

Our practice got a write off for cars going between offices, dinners taking out referral sources, travel to take care of business in the West Indies and so on.

I knew of an ENT who bought works of art and rotated them from his office to his home.

The question is how aggressive is your accountant and how your tolerance to IRS disputes. Unfortunately that type of information is hard to come by in a presentation to the general public.
 

Craig Steinberg OD JD

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Well.....a practice can net $300,000 and if the owner puts $300,000 back into the practice, that person isn't eating that year.

Obviously, that is an extreme and absurd example.

So the number I'm interested in is "how much money do you pull out of the practice for your personal enjoyment."
What does that have to do with managed care plans?

The germane question to me is, if you drop a plan, what's the impact on your bottom line, net revenue, after 1, 2, 3 years? And, secondly, what is the impact on the "enjoyment" and moral of you and your staff?
 
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Greg Luce

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What does that have to do with managed care plans?

The germane question to me is, if you drop a plan, what's the impact on your bottom line, net revenue, after 1, 2, 3 years? And, secondly, what is the impact on the "enjoyment" and moral of you and your staff?
Also can it be done without "selling" products, procedures and gizmos that one may not be enthralled with but they are revenue generators.

Also is this out of managed care or just out of vision plan managed care? We bill an awful lot of medical managed care. Are we ditching that too?
 
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susan resnick

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Well.....a practice can net $300,000 and if the owner puts $300,000 back into the practice, that person isn't eating that year.

Obviously, that is an extreme and absurd example.

So the number I'm interested in is "how much money do you pull out of the practice for your personal enjoyment."
Hi Ken,
I am hoping to answer your question. Our webinar addresses a bunch of stuff related to best practices for “honing” a practice in general, but focuses on “being your own boss” by not accepting a third party’s idea of how much you should charge for your services. Would love you to join us.
As far as your question here, I, too need a better definition of “money for personal enjoyment”. As a preliminary response: our practice is a subchapter S P.C. We take salaries plus quarterly distributions. Our net to the principal partners is roughly 22%
 
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susan resnick

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Also can it be done without "selling" products, procedures and gizmos that one may not be enthralled with but they are revenue generators.

Also is this out of managed care or just out of vision plan managed care? We bill an awful lot of medical managed care. Are we ditching that too?
Also can it be done without "selling" products, procedures and gizmos that one may not be enthralled with but they are revenue generators.

Also is this out of managed care or just out of vision plan managed care? We bill an awful lot of medical managed care. Are we ditching that too?
Also can it be done without "selling" products, procedures and gizmos that one may not be enthralled with but they are revenue generators.

Also is this out of managed care or just out of vision plan managed care? We bill an awful lot of medical managed care. Are we ditching that too?
Our talk specifies that one can ditch none, all or some. We talk about building services and a brand that “diversifies the practice’s income portfolio”
 

Frederick Frost

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When I take a class, watch a webinar or do anything with educational value, my hope is to get one idea to help my practice. I am confident this webinar will exceed this.
 

susan resnick

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When I take a class, watch a webinar or do anything with educational value, my hope is to get one idea to help my practice. I am confident this webinar will exceed this.
Uh oh the pressure is on:). Thanks for the positive outlook. We tried to hit many areas of interest and ti address new ODs and the more seasoned ones.
 

Greg Luce

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Our talk specifies that one can ditch none, all or some. We talk about building services and a brand that “diversifies the practice’s income portfolio”
While I cannot attend live that evening, regretfully, I am registered so that I can at least listen to it later. Thanks for your time.
 

Allan Panzer

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I applied...not sure I can be there, but at least I can listen. Probably better if I'm not there...

When I encounter doctors who say they taken no plans, I am always wondering...where did the patients come from who you employ all of these great idea on?

See, if I dropped my EyeMed, VSP, Davis, Specterable and on and on..well, the phone simply would not ring.

If the phone does not ring, I have no one to sell a neurolens to.

So, lets look at another angle...let's say the phone does ring...
Ring: Hello Ms Jones, how can I help you?
Well, I noticed from your excellent website that you specialize in scleral lenses...
Yes Ms Jones we do...why Dr. Panzer has been fitting these for many years and is quite the expert. Would you like to schedule an appointment?
Sure, do you take my XYZ plan..
No Ms, Jones as a matter of fact the doctor does not.

Well, thank you, I appreciate your time..CLICK!

See, it is the world in which we live. I think after 40 years and many recorded phone calls I've listened to from my office that is indeed the way it goes.

I had a surgeon's wife many years ago referred to me by a hospital practice. She had paid for RK..could not see and had an insurance that did not happen to pay for sclerals..now remember, she has a husband who is a physician..she says..

Well if it's not covered, I'll just go elsewhere..

But but but...No Buts..I'm going elsewhere..I'm sure someone will take my insurance.

But Ms whoever..you have Superior and they just don't pay! I'm on the lousy plan..

Sorry I'm leaving now.
 

susan resnick

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I applied...not sure I can be there, but at least I can listen. Probably better if I'm not there...

When I encounter doctors who say they taken no plans, I am always wondering...where did the patients come from who you employ all of these great idea on?

See, if I dropped my EyeMed, VSP, Davis, Specterable and on and on..well, the phone simply would not ring.

If the phone does not ring, I have no one to sell a neurolens to.

So, lets look at another angle...let's say the phone does ring...
Ring: Hello Ms Jones, how can I help you?
Well, I noticed from your excellent website that you specialize in scleral lenses...
Yes Ms Jones we do...why Dr. Panzer has been fitting these for many years and is quite the expert. Would you like to schedule an appointment?
Sure, do you take my XYZ plan..
No Ms, Jones as a matter of fact the doctor does not.

Well, thank you, I appreciate your time..CLICK!

See, it is the world in which we live. I think after 40 years and many recorded phone calls I've listened to from my office that is indeed the way it goes.

I had a surgeon's wife many years ago referred to me by a hospital practice. She had paid for RK..could not see and had an insurance that did not happen to pay for sclerals..now remember, she has a husband who is a physician..she says..

Well if it's not covered, I'll just go elsewhere..

But but but...No Buts..I'm going elsewhere..I'm sure someone will take my insurance.

But Ms whoever..you have Superior and they just don't pay! I'm on the lousy plan..

Sorry I'm leaving now.
Sorry you cannot be with us live, Allan. Yes, there are many patients who just cannot or will not go out of network. Location and demographics certainly are important predictors. Our talk emphasizes that the mix of third party and private pay will vary and can be manipulated over time. Practice analysis and willingness to take a bit of risk are essential. Seeing fewer patients while increasing income and professional satisfaction are a reality for many but not for all.
 

Jeffrey S. Filandro

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One of the problems with seminars like this....... and I realize that there really isn't a good way to get around the problem.......

How much money do these people put in their bank account? That's really the ultimate question here.

Not gross practice revenue. Not net practice revenue. Not percentages of this or that.

How much money did you take out of your business for your personal benefit and enjoyment?


It would be nice if there were a way to know that. It really would put these seminars in context.

Well said Ken.

Does anyone on ODwire doubt the earnings of our daily posting optometric business EXPERTS? or the poster who sold his collection of baseball cards for a million bucks? or the OD who got tired of everyone questioning his power practice and posted his QuickBooks register (that was amazing by the way)?

A VCP/medical model can say "how great thou art" all day and night... and have the Medicare earning/reporting website show otherwise.

It is requested over and over and over again....

Business tax return...page 1...block out the SS#, date of birth, all personal data except....da money.

Show me the money.

Every CE lecture in America starts out with the disclosures. To take the information presented, paid for, supported by AND miraculously available for purchase right after the lecture ends...in perspective.

I am not sure that anyone cares...but my corporate practice did well over $100K in VCP and wellness exams last year..and I never touched a pair of glasses or sold a single contact lens. My webinar will have 8 1099's available for you to inspect..and since it is under my tax ID and addressed to my business address which is all public records there won't be anything blacked out....

The only way to REALLY answer Ken's question of "how much did you take out" is to show us.
 

susan resnick

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Well said Ken.

Does anyone on ODwire doubt the earnings of our daily posting optometric business EXPERTS? or the poster who sold his collection of baseball cards for a million bucks? or the OD who got tired of everyone questioning his power practice and posted his QuickBooks register (that was amazing by the way)?

A VCP/medical model can say "how great thou art" all day and night... and have the Medicare earning/reporting website show otherwise.

It is requested over and over and over again....

Business tax return...page 1...block out the SS#, date of birth, all personal data except....da money.

Show me the money.

Every CE lecture in America starts out with the disclosures. To take the information presented, paid for, supported by AND miraculously available for purchase right after the lecture ends...in perspective.

I am not sure that anyone cares...but my corporate practice did well over $100K in VCP and wellness exams last year..and I never touched a pair of glasses or sold a single contact lens. My webinar will have 8 1099's available for you to inspect..and since it is under my tax ID and addressed to my business address which is all public records there won't be anything blacked out....

The only way to REALLY answer Ken's question of "how much did you take out" is to show us.
This webinar is not a financial seminar. Sorry!!!!
 
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Jeffrey S. Filandro

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This webinar is not a financial seminar. Sorry!!!!

Dr. Resnick... I apologize, I was answering Ken's general question about financial seminars and how can an interested viewer quickly KNOW if the presenter is "worthy".

I am 100% confident your webinar is factual and actual. Thank you for your service to Optometry as one of our true leaders and example setters for our profession.
 

Allan Panzer

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I did not say I would not be there, I said I might not be there..but that if I were not, I'd listen.

I am always willing to listen..even to Art's presentation yesterday when he refused to call on me after saying..'this is informal, just ask if you want me to answer a question" I hate hate hate those who do not speak the truth.

I put my hand up five times in the first minutes to ask a very simple question and I thought I'd have to stand up and yell at him. So, my saying you might not want me there is just because it is the way I am.

Speakers at lectures look in the audience and say..oh darn..there is that pain it the ass Panzer..He's going to ask me something. Actually they probably don't say "darn".

The second slide Art put up showed the sentence..Increased osmolarity drives dry eye!

I simply wanted to ask why he skimmed over it. He knows I think highly of dry eye testing...but did not want to address it..
So, sometimes you are better off without me. Everyone just nods their little heads and goes along.

Why would a lecturer not remove a sentence they do not believe in?
If the words "increased osmolarity drive dry eye". mean nothing..take the sentence out.

When he finally addressed my question his answer was..well I'm not changing my treatment based on osmolarity...
I realize I'm off topic.I just wanted to explain why I might be better off not listening live..because I question things..

It is who I am..like me or not..I ask pointed questions..and some speakers prefer not to have me live.
 

susan resnick

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Dr. Resnick... I apologize, I was answering Ken's general question about financial seminars and how can an interested viewer quickly KNOW if the presenter is "worthy".

I am 100% confident your webinar is factual and actual. Thank you for your service to Optometry as one of our true leaders and example setters for our profession.
No worries!! I am only seeing this thread in my phone because I am traveling and it’s really hard to follow the quotes and replies so I really have no idea to whom I am replying half the time!!
Anyway, let me just add: this webinar is designed to be conversational and fun snd to share Viola and my “journey”. Participants can take away good, bad, indifferent. But we felt compelled to “air” our learnings.
 

susan resnick

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I did not say I would not be there, I said I might not be there..but that if I were not, I'd listen.

I am always willing to listen..even to Art's presentation yesterday when he refused to call on me after saying..'this is informal, just ask if you want me to answer a question" I hate hate hate those who do not speak the truth.

I put my hand up five times in the first minutes to ask a very simple question and I thought I'd have to stand up and yell at him. So, my saying you might not want me there is just because it is the way I am.

Speakers at lectures look in the audience and say..oh darn..there is that pain it the ass Panzer..He's going to ask me something. Actually they probably don't say "darn".

The second slide Art put up showed the sentence..Increased osmolarity drives dry eye!

I simply wanted to ask why he skimmed over it. He knows I think highly of dry eye testing...but did not want to address it..
So, sometimes you are better off without me. Everyone just nods their little heads and goes along.

Why would a lecturer not remove a sentence they do not believe in?
If the words "increased osmolarity drive dry eye". mean nothing..take the sentence out.

When he finally addressed my question his answer was..well I'm not changing my treatment based on osmolarity...
I realize I'm off topic.I just wanted to explain why I might be better off not listening live..because I question things..

It is who I am..like me or not..I ask pointed questions..and some speakers prefer not to have me live.
 

susan resnick

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Allan: At the very least allow me to answer the osmolarity question. Increased osmolarity is a driver of inflammation which increases symptoms. You are right: it probably foes not cause dry eye but, rather, results from it.
 
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Joe DiGiorgio O.D.

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This webinar is not a financial seminar. Sorry!!!!

I like where this seminar was originally slated to go. We are always concerned about finance, but let's not derail the topic these two speakers are planning.
 
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Joe DiGiorgio O.D.

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When I encounter doctors who say they taken no plans, I am always wondering...where did the patients come from who you employ all of these great idea on?

See, if I dropped my EyeMed, VSP, Davis, Specterable and on and on..well, the phone simply would not ring.

If the phone does not ring, I have no one to sell a

Very valid point. We gotta get em in the door, and unfortunately these VCP directories seem to have become today's Yellow pages.

Trouble is I (we ) are hoping that the VCPs don't gut the reimbursements for our specialty care and for our medically billed evaluations and procedures.
 

Ken Elder

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would you share those specific numbers? seems a bit personal to me

No. And I didn't mean to imply I would.

But it shows the problem with seminars like this. There's a whole context that's missing. (I'm still planning on signing up.)

Almost everyone who "drops vision plans" says that their gross goes down and their net goes up. Are they talking actual net dollars in their practice or percentage net? Virtually every person I've seen discuss this has been referring to percentage net.

Ok.....that's nice. But did the percentage net go up enough to offset the decrease in gross?

And I get it......maybe the dollars in the owner's pocket went down a little bit but their amount of free time away from the office went WAY UP. I think most of us would probably make that trade. Is that happening for most people? I'll take a 10 percent payout if it means I get an extra day off a week and now I'm working 25% less.

In no way am I trying to impugn Dr. R or Dr. K. I'm sure they will put on a good seminar and I"m looking forward to it.

The problem for me is that in these situations there are always a lot of devils in a lot of details. It's like billing and coding. Most of the so called gurus in our field seem to be right only about 50% of the time. That's about as good as the IRS customer service hotline.
 

Allan Panzer

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Allan: At the very least allow me to answer the osmolarity question. Increased osmolarity is a driver of inflammation which increases symptoms. You are right: it probably foes not cause dry eye but, rather, results from it.
Not to start this..but Art said..he never decides treatment based on osmolarity..I find that statement to be wholly incorrect..but you can't argue with the "expert".

Even if he apparently has not read all the literature
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1755-3768.2013.S030.x

There is plenty of research into osmolarity...plenty..but alas they were not one of the sponsors..
 

Craig Steinberg OD JD

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No. And I didn't mean to imply I would.

But it shows the problem with seminars like this. There's a whole context that's missing. (I'm still planning on signing up.)

Almost everyone who "drops vision plans" says that their gross goes down and their net goes up. Are they talking actual net dollars in their practice or percentage net? Virtually every person I've seen discuss this has been referring to percentage net.

Ok.....that's nice. But did the percentage net go up enough to offset the decrease in gross?

And I get it......maybe the dollars in the owner's pocket went down a little bit but their amount of free time away from the office went WAY UP. I think most of us would probably make that trade. Is that happening for most people? I'll take a 10 percent payout if it means I get an extra day off a week and now I'm working 25% less.

In no way am I trying to impugn Dr. R or Dr. K. I'm sure they will put on a good seminar and I"m looking forward to it.

The problem for me is that in these situations there are always a lot of devils in a lot of details. It's like billing and coding. Most of the so called gurus in our field seem to be right only about 50% of the time. That's about as good as the IRS customer service hotline.
Ken, at the end of the day, that's a very easy question to answer. If the speaker provides their gross and net figures, you can probably calculate the "real" dollars in your head or on your smart watch. I know that the speakers at the Cleinman Exiting Vision Plans seminars that walk people through the results of exiting discuss real total dollars.

Really, what you are shooting for, I believe, is neutral. If you can eliminate ONE VCP and land with exactly the same take-home pay within a year or two, you've excised one malignancy, probably reduced your work load, improved your office moral, created more opportunity for non-VCP patients, and it cost you zero. Now start working on the next. It may take 5 years or more to eliminate them all, or you may find that you must keep one or two. But each one you CAN eliminate without losing $, you're just that much better off.

And note: it is my opinion that we are ALL going to lose VSP from our offices. VSP is building a network of VSP owned/operated offices. When they have a large enough network they will first incentivize their members to go to the VSP location, and within a few years after that will start selling plans to their employer-customers FOR LESS MONEY that requires the VSP patients/employees to go only to a VSP location.
 
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Joe DiGiorgio O.D.

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If you can eliminate ONE VCP and land with exactly the same take-home pay within a year or two, you've excised one malignancy, probably reduced your work load, improved your office moral, created more opportunity for non-VCP patients, and it cost you zero. Now start working on the next.

I love this concept. Sometimes I have found that a docs best friends and relatives still goes by their plan provider list. When their plan changes they call you and ask you to help them pick a new doc that will be as good as you. I explain that we are "extended network" and will be delighted to help them submit for "direct reimbursement", but when they find out that they actually have to pay, and will be directly reimbursed, they seem to develop constipation.

Wonder if we could improve this with a bit more coaching?
 

Joe DiGiorgio O.D.

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Also I am not sure how Susan & Viola do it, because IIRC, they are both active scleral lens fitters. When looking at sites like "My Big Fat Scleral Lenses" it sounds like if people do not have insurance coverage for their sclerals, many will choose to be visually handicapped rather than possibly think about investing in improving the quality of their lives.

(oops--hope I am not derailing the thread).
 
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What does that have to do with managed care plans?

The germane question to me is, if you drop a plan, what's the impact on your bottom line, net revenue, after 1, 2, 3 years? And, secondly, what is the impact on the "enjoyment" and moral of you and your staff?
I actually have those metrics and have shared them in the webinar in a graph as I purposely tracked this very number. I was personally shocked at the results...
 
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No. And I didn't mean to imply I would.

But it shows the problem with seminars like this. There's a whole context that's missing. (I'm still planning on signing up.)

Almost everyone who "drops vision plans" says that their gross goes down and their net goes up. Are they talking actual net dollars in their practice or percentage net? Virtually every person I've seen discuss this has been referring to percentage net.

Ok.....that's nice. But did the percentage net go up enough to offset the decrease in gross?

And I get it......maybe the dollars in the owner's pocket went down a little bit but their amount of free time away from the office went WAY UP. I think most of us would probably make that trade. Is that happening for most people? I'll take a 10 percent payout if it means I get an extra day off a week and now I'm working 25% less.

In no way am I trying to impugn Dr. R or Dr. K. I'm sure they will put on a good seminar and I"m looking forward to it.

The problem for me is that in these situations there are always a lot of devils in a lot of details. It's like billing and coding. Most of the so called gurus in our field seem to be right only about 50% of the time. That's about as good as the IRS customer service hotline.
You are exactly correct. Funny - I actually have a slide called, "The Devil is in the Details." Because you are correct. I also included a graph with real practice numbers, tracking the growth in gross as I transitioned from taking VCPs to NOT taking them...
 
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