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AOA to Congress and Obama administration: Act now to avert looming Medicare pay cut

September 1, 2012

While work continues to ensure that ODs and patients are treated fairly under health care reform, the AOA and other physician organizations are now placing increased pressure on Congress and the Obama administration to find the equitable solution needed to avert a massive Medicare pay cut set to take effect at the end of this year.

Without corrective action, ODs and other physicians will see a nearly 30 percent reduction in Medicare reimbursement rates starting Jan. 1, 2013.

Knowing the pitfalls of these drastic reductions or even the uncertainty from the threat, the AOA is now urging Congress and the administration to act quickly to protect patients and providers from these potentially disastrous cuts.

Leading the charge, Dori Carlson, O.D., then-AOA president, and Ron Hopping, O.D., then-AOA president-elect, presented a united front for optometry in early June at a special White House meeting with U.S. Department of Health & Human Services Secretary Kathleen Sebelius, Obama administration health policy officials, and representatives of other physician groups.

At the invite-only meeting, which mainly focused on health care payment and delivery reform, Drs. Carlson and Hopping used the extraordinary opportunity to provide optometry’s perspective on care coordination and quality issues and emphasized the essential role that optometrists play in providing primary care and the need to eliminate health plan and other barriers to patient access to full-scope optometric care.

“Doctors of optometry have historically been and continue to be providers of first-contact care for basic health services that are needed by most or all of the population as optometrists perform needed eye examinations for the overwhelming majority of Americans,” Dr. Hopping said.

“Doctors of optometry are among the only primary care health care professionals many relatively healthy patients see, and as a result, optometrists continue to play a critical role in the delivery of primary and systemic preventive care and serve as a critical entry point into America’s health care system,” Dr. Hopping said.

“As our health system changes and we make strides toward a quality-enhancing payment mechanism, the AOA believes that efforts must be focused on increasing access to services that ultimately decrease the need for costly procedures,” Dr. Hopping added.

“While optometrists are primary care providers for essential vision and eye health services that often reduce the need for costly interventions, many new payment and delivery models either exclude or fail to value the key role that doctors of optometry play in reducing overall costs through improved access to preventive and primary care services as well as increased provider competition in the health care marketplace,” added Dr. Hopping.

“The reality is that, in practice, many secondary and tertiary providers rely on primary eye care management provided by optometrists, but top-down policies too often discourage these efficient approaches and transitions developed locally. While optometrists stand ready to provide further help, policymakers would be well-served to not let old biases and misplaced motivations derail overall efforts to increase quality and reduce health care costs,” Dr. Hopping concluded.

As Drs. Carlson and Hopping were providing a united front for optometry at the White House, the AOA was also making its voice heard on these issues on Capitol Hill.

In response to a direct request from U.S. House Ways and Means Committee Chairman Dave Camp (R-Mich.), the AOA reinforced optometry’s key role in efforts to promote value-based measures and practice arrangements that can improve health outcomes and efficiency.

In comments delivered directly to Ways and Means Committee members and staff, AOA again stressed that the drive to transform the current Medicare payment system must be focused on increasing access to services that ultimately reduce the need for costly procedures down the road rather than limiting access to certain services based on old biases and misplaced motivations.

“Optometrists are motivated to participate in efforts to improve quality and efficiency and we believe that we bring a unique perspective because optometrists are primary care providers for essential primary care vision and eye health services that reduce the need for preventable and costly interventions,” the AOA said in a detailed response to Chairman Camp and members of the Committee.

“As you move forward, AOA urges the committee to remember that previous efforts to manage care and costs failed because utilization was restricted based on non-medical reasons. If policymakers are serious about reducing costs and finding increased efficiency, America’s doctors of optometry must be viewed as a key part of the solution,” the letter said.

Among other issues addressed in the AOA’s comments, the committee was also reminded that AOA members continue to experience discrimination in some Medicare policies merely because of where the optometrist went to school, and this causes enormous and unnecessary burdens for ODs who wish to provide care they are trained and licensed to do, and unfairly limits patient access to needed care.

“Medicare should not limit the care that optometrists are state-licensed to provide – care that optometrists legally provide to non-Medicare patients – merely because of the opinion of some policymakers about the value of the educational degree that optometrists hold,” the AOA asserted.

With a massive Medicare pay cut scheduled to take effect at the end of the year and ongoing efforts to transform health care delivery and payment, ODs and optometry students are urged to join the AOA’s ongoing advocacy in the nation’s capital by contacting the AOA Washington office team at 800-365-2219 or ImpactWashingtonDC@aoa.org.

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