Dare to be Different: Achieve Independence from Managed Care

Jeffrey S. Filandro

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I'll use a weak analogy. Store X advertises a $9 widget.

This REALLY really resembles my corporate office.

Me "This rack of frames is $9. They are covered in full under your insurance."

Px "but I like the $159 frame better"

Me "That's great !!!! the $150 difference is due before we send out the order to the lab"

Nothing has happened that caused the patient to be inconvenienced...upsold...or baited and switched.

The patient can get nothing and like it....the covered frame without paying a dime...or pay for what they want.

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

If a patient comes into our office with their VCP plan in hand, because they sat on their glasses, and they've got 30 IOPs and .8 cups, it is NOT bait and switch to say, oh, by the way, you may be going blind and we need to evaluate you for what appears to be glaucoma, but that's not covered by your VCP plan.

This really really really represents BOTH my offices....

Me "your elevated IOP and .8 cups require ADDITIONAL treatment and testing."

Px "well I really only wanted to do the broken glasses today"

Me "that's fine..the new laws in Maryland/the established laws of Delaware allow you to return and address the medical problems here under your medical insurance..or you can go see another local provider"

No bait. No switch. Patient can see me for treatment...see a local OD/eyeMD...or they can get the dismissal letter and go blind.

The only thing that isn't happening is treating anything besides optical correction with a VCP.
 
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Paul Farkas

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Robust conversation even before the Webinar. This is a first for ODwire.org.

One thing to understand is that the presenters are both practice in New York City. They hopefully will explain the impact of Vision Care Plans on their market base.

ODs will be viewing and participating nationwide. The infiltration of Vision Care Plans will vary based on location. In addition, some ODs practice in large rural states where they could be the only game in town for many inconvenient miles.

I wonder if Canadian ODs will sign up although Vision care Plans are not an issue in Province.
 
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Allan Panzer

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Mar 3, 2002
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So, there is a dry eye group on the other social media.

They asked me ...me to do a webinar..I said..sure.

The participants began writing in their questions..silly little basic ones..I answered..the moderators got angry and said..stop that there won't be any questions for the webinar.

Sort of like what you are saying only in reverse. You actually want discussion..ahead of the webinar.

Oh and a follow up..for some unknown reason they decided that I was too..whatever..and they banned me from the site..can you imagine..Like I was XYZ...on ODwire.
Anyhow...now for the rest of the story. They wanted me to do the webinar..

Really? I'm going to help you promote your site because folks want to hear me, but I am banned.

I told them I would not help them ..they ought to have waited a while before kicking me off..

And I ought to have done the webinar and told everyone that they could not have asked me any additional questions because although I was good enough to give my time for free, I wasn't good enough to be on the FB page..

Guess we all make mistakes.
 

AdminWolf

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Robust conversation even before the Webinar. This is a first for ODwire.org.

One thing to understand is that the presenters are both practice in New York City. They hopefully will explain the impact of Vision Care Plans on their market base.

ODs will be viewing and participating nationwide. The infiltration of Vision Care Plans will vary based on location. In addition, some ODs practice in large rural states where they could be the only game in town for many inconvenient miles.

I wonder if Canadian ODs will sign up although Vision care Plans are not an issue in Province.

We have done literally hundreds of shows on ODwire.org over the years.

This event is different; it isn't for everyone. But it is one of the rare ones that can be truly transformational to the lives of a select few clinicians that decide to take its message to heart and follow through.

Hopefully it will guide some people on a new path, and that's why i'm really looking forward to it!
 
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Jeffrey S. Filandro

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I don't think that you can transfer what can be done in NYC to anywhere else. Medical services are a different animal there. Try and find a physician that accepts Medicare.

Know thyself.

Every practice has its own heartbeat.

My practices beat to the drum of 2.5 million dollars of primary care per year.

But..if I had the choice to "go for it"...I would :)
 

susan resnick

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Jan 10, 2001
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I don't think that you can transfer what can be done in NYC to anywhere else. Medical services are a different animal there. Try and find a physician that accepts Medicare.
Great point, Fred...yes location has a lot to do with it...BUT that being said, we did an informal poll before deciding to do this webinar and there were MANY practices around the country who reported taking no third party....we are hoping to engage people from all over who have interest in learning how to reduce dependence on managed care...baby steps!
 

Morris Neel

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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.


You are 100 % correct.. my MD needs cat Sx but his deductible is $5 k !
Medicine costs for him has skyrocketed
So he is going to put it off. Patients don't have the income to pay us what we are worth. They are forced to pay it elsewhere drug costs etc. that continues to go up unabated,,
Because drug companies have gone to Congress to protect their turf,,
( we failed to do the same ! But we still have Board Certified!!)


Eyecare has been has been cheapened in the public eye by insurance and vision plans and cheap Contacts that they can get w no Rx by mail / internet ..

So in their mind if you don't take their insurance then they will go somewhere else who is almost as good in their minds and maybe equal ..and for less $ ..
So why go see you even if you are in Rotary club together and been a patient for 20 years!!

I learned this lesson 15 yrs ago ..
Patient loyalty is now gone ( has been really for 10 years)

Medicine is going through the same thing .. United health care is telling a group of docs in New Jersey that they will be eliminated from their network.. thousands of patients will be forced to go to a clinic owned by ..... you guessed it UHC,,

Where is it written that insurance companies are guaranteed a profit ..
Done.
 
Dec 26, 2001
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www.acuitynyc.com
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Manhattan
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I'd like to say something to all those who say "You can't do that here, everyone has VCPs and there is no patient loyalty, and NYC is a different planet!"

First of all I agree, NYC IS a different planet - a beautiful, hectic, crazy, competitive planet where everything costs 25 times more, there is no room to move or breathe, and if the patient doesn't like you they can seek care at the three practices within a two minute walk.

I agree that patients aren't loyal. I see my colleagues' disloyal VCP patients ALL DAY LONG.
When I dropped VCPs I lost some patients, of course. I have a little window in my custom-designed EHR that signals myself and my staff that a patient is a PIA.

You know what? That pop-up almost completely disappeared when I dropped the VCPs. Those are the patients I lost. I did not shed any tears. Until about two years later when they started trickling back in despite my best efforts to discourage them by pointing out that I DO NOT AND WILL NOT take their VCP.

I even gave them a list of docs nearby who do participate in their plans. They told me they went there, got their "free" eye exam, and now didn't mind paying for a "regular eye exam" at my office. No loyalty whatsoever...

My point is, you don't know until you try and your patient base is what you make of it. The day you stop whining about how organized optometry is failing to educate the public about the value of proper eyecare, and start educating your own patients, is the day you might find optometry is a very enjoyable and rewarding pursuit indeed.
 

Richard Pagan

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I don't think that you can transfer what can be done in NYC to anywhere else.

NYC also has plenty of 100% VCP, routine vision, optical type practices. Like many OD's on odwire, I imagine they also rationalize their business model as well.
 

susan resnick

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Jan 10, 2001
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I'd like to say something to all those who say "You can't do that here, everyone has VCPs and there is no patient loyalty, and NYC is a different planet!"

First of all I agree, NYC IS a different planet - a beautiful, hectic, crazy, competitive planet where everything costs 25 times more, there is no room to move or breathe, and if the patient doesn't like you they can seek care at the three practices within a two minute walk.

I agree that patients aren't loyal. I see my colleagues' disloyal VCP patients ALL DAY LONG.
When I dropped VCPs I lost some patients, of course. I have a little window in my custom-designed EHR that signals myself and my staff that a patient is a PIA.

You know what? That pop-up almost completely disappeared when I dropped the VCPs. Those are the patients I lost. I did not shed any tears. Until about two years later when they started trickling back in despite my best efforts to discourage them by pointing out that I DO NOT AND WILL NOT take their VCP.

I even gave them a list of docs nearby who do participate in their plans. They told me they went there, got their "free" eye exam, and now didn't mind paying for a "regular eye exam" at my office. No loyalty whatsoever...

My point is, you don't know until you try and your patient base is what you make of it. The day you stop whining about how organized optometry is failing to educate the public about the value of proper eyecare, and start educating your own patients, is the day you might find optometry is a very enjoyable and rewarding pursuit indeed.
Same here Viola...each year most of the patients who leave us to try "plan doctors" sheepishly return.
 

AdminWolf

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I just signed up for the webinar. When the time comes, how do I get into it?
The system will send you a reminder with a URL the night before, and the day of.

If you don't get one, you always know where to find me :)

thanks
Adam
 

Ken Bova

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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
If I dare to stop taking any vision insurance in the area I practice, I would lose 100% of my patient base.
 
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Craig Steinberg OD JD

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If I dare to stop taking any vision insurance in the area I practice, I would lose 100% of my patient base.
Maybe you’re asking the wrong question. How about, is there a vision plan I could drop?
 
Jun 5, 2006
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www.chicopeeeyecare.com
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NECO
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Chicopee
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MA
Our group practice is in a low socioeconomic area of MA and we take no vision plans. I will attend this seminar out of curiosity but based on the sponsors for the presentation, I think we're on the same page. Here is how we do it.
1. Personalized care. We are not a commodity. We are different from our competition. It's a cliche but we treat our patients like family.
2. High-quality care. High tech instruments, great staff including top-notch technicians, lots of urgent care visits every day, "24/7" coverage, to name a few.
3. Unique niche. Ours is geriatric care and scleral lenses and other lenses for keratoconus. For others, it may be dry eyes, children's vision, low vision.
4. Authority marketing. We accept television interview requests (e.g. 2018 solar eclipse), write articles, lecture and speak to various groups, have a large social media and PR exposure, including YouTube videos, all at little or no cost. Marketing people call it omnipresence."

In summary, most of our revenue comes from services, not selling glasses or contact lenses. I realize this strategy doesn't work for everyone and I have friends who do well with certain vision plans but for us, optometry is fun and professionally satisfying. I am happy to share a handout we give to every patient titled "3 things we want you to know about Chicopee Eyecare in 2020."
 

susan resnick

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If I dare to stop taking any vision insurance in the area I practice, I would lose 100% of my patient base.
How about adding non-covered services to enhance care and deepen an area of professional interest with the added bonus of generating income?
 

Richard Pagan

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I wonder how many MDs or DDSs are going through this effort to get out of managed care.

those professions are filled with self assured smart people with spines and usually they have enough self respect to not allow themselves to be paid such meager reimbursement.
 
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Joe DiGiorgio O.D.

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Any of you docs signed up for this event tonight? It sounds like the two presenting docs have made a lot of effort and it is worthy of your time.

I am wondering what shoes Dr. @Viola Kanevsky will wear to the webinar? (she has a reputation for having quite a collection).
 

William R. Hall

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Any of you docs signed up for this event tonight? It sounds like the two presenting docs have made a lot of effort and it is worthy of your time.

I am wondering what shoes Dr. @Viola Kanevsky will wear to the webinar? (she has a reputation for having quite a collection).
Wonder if her hair smells good too? If so, she best stay away from Biden.
 

Paul Farkas

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In order make plans for those registering the last minute...

The full length of the program is now scheduled for 3 hours...8PM ET(5PM PT)-11PM ET(8PM PT).
 

AdminWolf

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In order make plans for those registering the last minute...

The full length of the program is now scheduled for 3 hours...8PM ET(5PM PT)-11PM ET(8PM PT).

I've scheduled it for 3, but it probably won't run that long -- I just didn't want the software to cut us off if we ran long, so extended the conference.

I have to admit, I was taken by surprise by the response we've got to this show -- there should be a couple of hundred of docs here tonight. People are clearly looking for solutions...
 
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Philip Wren

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I've scheduled it for 3, but it probably won't run that long -- I just didn't want the software to cut us off if we ran long, so extended the conference.

I have to admit, I was taken by surprise by the response we've got to this show -- there should be a couple of hundred of docs here tonight. People are clearly looking for solutions...
IIRC, you mentioned the webinar will be available On Demand after. Any chance it will be on YouTube so it can be watched at a faster speed for those that don't have a Premium Vimeo account?
 

Joe DiGiorgio O.D.

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Wonder if her hair smells good too? If so, she best stay away from Biden.

My comment was not in any way intended to be off color, and Bill I am pretty sure you are not implying that. If you know Viola, you know that she has a world class shoe collection.
 

Joe DiGiorgio O.D.

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IIRC, you mentioned the webinar will be available On Demand after. Any chance it will be on YouTube so it can be watched at a faster speed for those that don't have a Premium Vimeo account?
Ohhh, I love 1.2 to 1.25X.
 

Paul Farkas

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I am registered. So if I can't listen to the presentation tonight, I can on another night. Correct?

As soon as Adam can catch his breath it will become "on demand" for registered ODs.
 

AdminWolf

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Thanks everyone for a fun show, I'm working on the archive right now, the link will be e-mailed to everyone that registered for the event.

-- ad
 

Paul Farkas

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For those attending...

This was a first for ODwire.org charging a nominal fee to attract outstanding presenters and topic for a Webinar. This Webinar has the added advantage of receiving useful speaker hand outs.

Was the effort worth the $19 price for admission?
 
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