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AOA Third Party Center shares benefits integration message at worldwide health plan conference

June 4, 2012

The Third Party Center team exhibited in the main exhibit hall at the World Congress 2nd Annual Leadership Summit on Ancillary Products and Voluntary Benefits and talked to health plan and benefits executives about the importance of integrating the eye health benefit into the health plan. From left, Mark Marciano, O.D., David Talley, O.D., Stephen Montaquila, O.D., and Lendy Pridgen.

Stephen Montaquila, O.D., chair of the AOA Third Party Center Executive Committee, explained the benefits of integrating vision and eye health benefits in health plan benefits packages at the World Congress 2nd Annual Leadership Summit on Ancillary Products and Voluntary Benefits in March. Dr. Montaquila shared the podium with Peter Hollmann, M.D., associate medical director of Blue Cross Blue Shield of Rhode Island. The conference was part of the larger Health Plan Innovation Congress.

Their session, “Integrating Vision & Eye Health Benefits and Professional Optometric Services,” was the first presentation showcasing the AOA’s Patient Access to Optometry message.

Dr. Montaquila discussed the importance of eye health as an integrated benefit in the medical plan, and Dr. Hollmann explained how integration was beneficial for Blue Cross Blue Shield Rhode Island members and the health plan. Together they described how the eyes and eye health are not ancillary and therefore should not be considered an ancillary benefit.

In addition to the presentation, the Third Party Center team exhibited in the main exhibit hall and talked to health plan and benefits executives about the importance of integrating the eye health benefit into the health plan.

Dr. Montaquila was joined by AOA Third Party Center Director Lendy Pridgen, committee member David Talley, O.D., and Mark Marciano, O.D., of the Florida Optometric Association. Nidek Inc. provided a retinal camera for use at the booth.

Patient Access to Optometry Campaign

Through the Third Party Center’s Patient Access to Optometry Campaign, optometry can demonstrate that it’s part of the solution to the nation’s health care crisis. Optometrists offer better outcomes, improved quality of care, direct provider access and cost savings.

Optometrists provide 70 percent of all eye care services in the United States and practice in more than 6,500 communities. In more than half of those communities they are the only source of eye care.

The campaign is centered on demonstrating the value of optometric services, the costs associated with a poorly designed delivery system, and the benefits of employing a practical approach to problem-solving.

Integrating eye care benefits into third-party plans is best for payers, purchasers and patients.

With a focus on current marketplace trends and analysis of issues facing optometry, the benefits are very tangible.

As part of the analysis, the center authorized a study of claims paid and quantified the value of services provided by optometrists.

The results showed a vast savings when comparing patient encounters with ODs to those with emergency departments or primary care physicians.

Diverting non-emergent care from emergency departments to primary eye care settings could have saved third-party payers more than 90 percent during the four-year period included in the study (2006 to 2009).

“Both the Florida Health Management Decisions, Inc. study and the AOA-commissioned research conducted by Solucia/ SCIOinspire demonstrate the benefits of including optometrists on medical panels and of encouraging patients to utilize our services,” said Dr. Montaquila. “Optometric offices are clearly the right setting for receiving the right eye care at the right time. By providing medical eye care services in our offices rather than in more expensive emergency department settings, we not only provide a higher quality of overall care in a convenient setting, but also offer significant savings to both patients and health plans.”

In future studies, the campaign will target research on the cost savings from drugs incorrectly prescribed and the cost implications of early detection of systemic disease.

For more information, contact Lendy Pridgen at lpridgen@aoa.org or call 703-837-1011.

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