Opportunity INTRUSION MEDICAL PLAN PARITY You Get to Choose – Will You Choose SOCIAL WILL MY EHI KIOSK CARE DISPENSARY GROW AUDITS Wisely? MEDIA COBWEBS?
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5/30/2019 Financial Disclosures – Joe DeLoach, OD, FAAO I Have Received Honoraria From or Served as a Consultant for: Chaos in a (Partial Listing) Changing • Vision Source • OfficeMate • Essilor of America Over half the state • Alcon Laboratories • Marco • Pearle Vision / SNAPP optometric Healthcare World • Carl Zeiss Meditec • TSO • Vision West associations • Optos • NVision • EyeMart Express Subtitled: How will you • Diopsys • Kowa • Cleinman Partners • UHCO, RSO, UAB, There are no conflicts or disclosures related to any of celebrate 2020? • PCS • Vision Trends Berkley, and other these groups • AllDocs optometry schools • Konan Joe W. DeLoach, OD, FAAO Practice Compliance Solutions, LLC – President and CEO (no financial interest) Clinical Professor – University of Houston College of Optometry (opinions do not necessarily reflect the views of the Practice Compliance Solutions University) Let’s start with some Can you join me in a feeling? TRUTH! (rare commodity these days – check out social media!) Isn’t just great to If ODs don’t stop thinking like doctors and start thinking like be an patients and businesspeople, the optometrist? CAN I GET AN next decade is going to be very AMEN! rough on their pocketbook! HIPAA OBAMACARE, IS MY TRUMPED-UP OSHA HEALTH CARE PRACTICE CARE OR NEXT? ACO CDC REFORM SAFE? MIPS / MAPS HEALTH CARE 1800 HEALTH CARE EXCHANGES Fear TECHNO CARE TOO MANY, NOT Or ENOUGH ODs? ON LINE EXAMS VISION PLANS OPHTHALMOLOGY Opportunity INTRUSION MEDICAL PLAN PARITY You get to choose – will you choose SOCIAL WILL MY EHI KIOSK CARE DISPENSARY GROW AUDITS wisely? MEDIA COBWEBS? 1 5/30/2019 What Challenges Face Optometry in the Next Decade? • A totally new reimbursement system • A new kind of patient A New World of Health • Increased competition Care Reimbursement • Optometry (really?) • Tele / Techno Care Primary Care as a “loss leader” Encounter Based Payment System Marketing is marketing. Loss leader Typical glaucoma suspect encounter payment 2018 marketing has always worked – The Initial office visit ($129), follow up visits ($79 x 2), scanning public doesn’t go to particular grocery laser ($45 x 2), visual fields ($83 x 2), gonioscopy ($30), store because bread sale for a buck? pachymetry ($15), ERG ($85) TAKE HOME: Approaching $700 Who is driving the primary care loss leader concept? Glaucoma suspect diagnosis payment circa 2020 • Wellness plans in major medical Fee for managing a glaucoma suspect for one year time frame • The vision plan “race to the bottom” TAKE HOME: $283 • Some companies like ones who think they are “Best” PQRS, MACRA, MIPS – What it is THIS IS A PROBLEM WHY? REALLY about and where will it go? Who says it is? Not the public • Is the concept of QUALITY measurement rational? Not the health care system • How the Public Will Use This It is CHANGE – plain and simple • Access the “Quality Scores” • 2016 - 17K business information searches PER MINUTE – and what are they finding? YOU DO WHAT ABOUT IT? • How the Payers Will Use This 1. Play the game • Panel inclusion based on WHAT? Let’s look at a totally 2. Be a maverick IRRATIONAL idea that is our future. 3. Advocacy in DC and your state capital – but advocate for WHAT? 2 5/30/2019 WHO IS YOUR NEW CUSTOMER - excuse me I meant patient E-Patient A New Patient “An individual who is equipped, enabled, empowered and engaged in their health care and their health care decisions” Tom Ferguson, MD E-patient characteristics that likely apply to us - and you may or may not like! America’s “Climate of Distrust”* Believes in augmented nutrition Believes in natural / alternative medicine This is the challenge facing all business due to: Willing to research to achieve an over-qualified patient status (“care-hacking”) Proliferation of fake news Unmet service/product promises Future success will depend on: Accepts “non-MDiety” interfaces (woo-hoo!) Corporate / business misdeeds An uncompromising business ethic Accepts virtual medicine and virtual counseling Attention to consumer desires Global financial crisis Desires control over their health care decisions Total transparency Lack of privacy assurance Contribution to the general good Desires alternative sources of health care information, services and products * NAVEX Global “Top Trends in 2019” Values experience and “fun” – ASSUMES quality THIS IS A PROBLEM WHY? Who says it is? Not the public Not the health care system It is just CHANGE – plain and simple Competition YOU DO WHAT ABOUT IT? Quit thinking like an optometrist Read the book 3 5/30/2019 COMPETITION Vision plans may be great, but… Vision Monday 2019 Is not a four letter word….it is spelled • There is massive intra-industry competition that will continually drive a VSP“race Global to the to bottom” Expand Retail Strategy, Open EyeConic Stores and Launch• Wellness VSP care Ventures as simply a loss leader? Some primary medical care Vision Plans (“diabetic exams”) thrown in for good measure? EyeConic = Retail “store” wholly owned and operated by VSP Ophthalmic products as a commodity • They will become major direct competitors – VSP Direct, VSP Vision VSPCenter Ventures = Acquisition model Ophthalmology • Marchon and VSP? EyeMed and Luxillor? Remember – VERTICAL Technology WHY?INTEGRATION! “because doctors asked VSP for these alternatives” • The REAL PROBLEM - they are all like heroin and many of our colleagues, LET”S LOOK AT THESE…. any maybe you, are hooked on them Characteristics of Addiction • Depression • Delusional actions What did total • dependency on one Avoidance of reality product line do for • Focus on maintaining the addiction some folks • And, of course, itching and constipation Warbyparker.com Collinsbridge.comWhat MAJOR industry Product competition – old news, no Eyebuydirect.com Eyeglasslensdirect.com I easily found (quit looking) leader said – “ODs are news or news we just like to ignore? Glassesusa.com Statscrop.com Zennioptical.com Izito.com either unaware of or As far as non-health care provider invasion into ophthalmic 59 onlineFramesdirect.com opticals andOberlin.com 49 are inflating their products….a few quotes: Globaleyeglasses.com Lenscrafters.comoptical capture rate” contactGlassesshop.com lens order Replacelens.comsites “Change does not occur based on our ability to Eyeglasses.com Superfocus.com (including39dollarglasses.com several visionPaylesseyewear.com plan They’re ignoring all stomach it” Flannery O’Conner Glasses.comsites) Jemoptical.com this why? Justeyewear.com Optical4less.com QUOTE - “We cannot change anything until we accept that Coastal.com Cheapglasses123.com Eyeglassguide.com Lensesrx.com “they aren’t sick it has changed” Carl Jung AndClearlyglasses.com is it really 8%?Eyefly.com enough yet” 4 5/30/2019 CNBC 11/18/13: For the first time in history, online shopping overtakes “brick and mortar” as the preferred choice for US shopper (63% online vs 37% traditional) – 2016 $175 MILLION PER HOUR It has little to do with the doc, how many frames they have, one day service, exceptional staff, or whether or not they stock Maui Jims….. IT IS ABOUT CONTROL, CONVENIENCE AND THE “EXPERIENCE” – THE STORY OF ROSIE Per Ernst & Young 2017 report – “72% of Millennials prefer to Until optometry starts to believe the spend money on experiences rather than goods” public thinks these are ALL the same WHAT DID YOU BUY ONLINE THIS MONTH? thing, the future is not so bright! OR LAST NIGHT? Worried about Warby Parker? How about patients THIS IS A PROBLEM WHY? just making their own glasses? Who says it is? How to 3-D print sunglasses Not the public Not the health care system Published on Apr 13, 2016 It is CHANGE…plain and simple I had a pair of broken glasses that have been sitting on my desk for the past few months. After a few trial and error attempts I managed to design a pair of glasses that worked well. Hard cost - $6.33. Published on May 6, 2015 I DO WHAT ABOUT IT? In this video I show you how to design and 3D print your own pair of sunglasses! You can find my design files below: http://www.thingiverse.com/thing:813228 1. Don’t put all your eggs in one basket – OPTOMETRY IS MUCH MORE THAN JUST SELLING China just built EVERYTHING in a 6-story GLASSES AND CONTACT LENSES building using 3-D printing! Do you feel you are swimming upstream? And our own worse enemy is who? Or are you asking the wrong question??? Let’s look how some are answering this “challenge”? 5 5/30/2019 What does this tell your patients? Public perception of optometry should be WHAT’S ON YOUR FRONT blamed on DOOR, WINDOW, WEBSITE, WHO? BUSINESS CARD? Or…. Private equity POSSIBLY Two PE Players attractive but UNLIKELY option because: • Us (really?) 1. Proper practice exit strategy • Major interest is mega practices takes minimum of five years • More medical than optical • More hands off 2. PE (practice acquisition) is • Are they really bad for optometry? often not all it’s cracked up • The Giants to be • Major interest is acquisition Let’s look at 3. Who are the PE players and • Almost total focus on optical these folks!!! what do they want? • VERY hands on JUN 9, 2017 @ 12:14 AM 5,217 12 Stocks to Buy Now RETAIL COMPANY 2017 PERCENT China's Largest Eye Doctor Chain Is Looking To Expand To The U.S GROWTH It’s not VisionWorks, Warby Parker 140% LensCrafters, Pearle - add in Ellen Sheng , CONTRIBUTOR Main mode of “expansion”? Opinions expressed by Forbes Contributors are their own. EyeCare Partners (Clarkson) 85% all the familiar names Vision Precision (Stanton) 41% Sheng: Aier now has one location in the U.S. ACQUISITION- formerly Wang Eye MOST ARE ACQUISTION Institute. What’s next? Capital Vision (MyEyeDr) 35% Wang: We are first looking at rural areas in Tennessee. We are National Vision (Americas Best+) 21% COMPANIES looking for rural areas with unmet needs.