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AOA leaders name reform implementation as next challenge, opportunity
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ORLANDO, Fla. – Here at Optometry’s Meeting, the American Optometric Association presidents challenged the state leaders “to be relentless and steadfast in standing up for optometry and our patients” as the Quality, Affordable Health Care for All Americans Act is implemented.
In his inaugural address to the AOA House of Delegates, incoming President Joe E. Ellis, OD, said, “Optometry’s greatest challenge with health care reform will be in its implementation. Optometry’s greatest opportunity will be its implementation. As leaders of our profession we have a once-in-a-lifetime opportunity to help define the role of optometry in the U.S. health care system for decades to come.”
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During an AOA-sponsored press conference, outgoing President Randolph E. Brooks, OD, outlined the AOA’s battle for nondiscrimination language to be included in the health care reform legislation, specifically to provide coverage for the 70 million people insured through ERISA (Employee Retirement Income Security Act) plans.
“Five years ago when we started, we couldn’t match the anti-optometry agenda groups and couldn’t match insurers in terms of dollars, but we outworked them,” Dr. Brooks said. “Our formula at the state level was multifaceted, grass roots involvement and a key message.
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“For 35 years ERISA was a barrier,” he continued. “Fifty-five percent of American workers
were covered by ERISA programs (73 million people). The ERISA barrier will be breached in 2014 when the Harkin Amendment takes effect. Insurers will no longer be able to discriminate against ODs providing care under their scope of practice. We know the amendment will not end unfair treatment of ODs with regard to reimbursement; however, the bill links reimbursement to quality and performance measures.”
State exchanges
“Now the hard work comes – the implementation of health care reform,” Dr. Ellis said at the press conference. “The good news for optometry is we do not have a single health exchange out there, but will have 50 state-based exchanges that will be totally different from state to state.
“It will take all we have to work out the various state exchanges,” he continued. “The AOA will have to work on defining what the state regulations are. We have a relatively tight deadline. Implementation efforts are going on today.”
“Yes, we anticipate push-back from ophthalmology,” Dr. Brooks added. “Getting plugged in on a state level will be every bit as important as it was for scope of practice.”
Children’s vision
Press conference organizers played a video recording of U.S. Department of Health and Human Services Secretary Kathleen Sebelius accepting the AOA’s Health Care Leadership Award. “Since President Obama took office, this administration has undertaken a broad agenda: to give Americans more control of their health care,” she said. “You will play a key role in achieving that goal. Thanks to the work of the AOA leadership, we have a new law that provides greater access to vision care for all Americans, including children.
“Last month, 75% of children covered by Medicaid didn’t receive their required vision screenings,” she continued. “I prepare to tackle that problem by making a comprehensive eye exam an essential benefit.”
Secretary Sebelius also commended the 7,000 volunteers in the AOA’s InfantSee program. “This is just the kind of preventive care we need as part of this patient care act,” she said.
Dr. Ellis also covered children’s vision in his presidential address to the House of Delegates. Three states – Kentucky, Illinois and Missouri – have school entrance eye exam laws. “A recently published study demonstrated that the schoolchildren in Kentucky had an improvement in their test scores,” Dr. Ellis said. “Despite this, there still remains a core group of detractors who choose to ignore the data ... and continue to oppose this basic right for children. It’s time for all states to join the first three and fight on behalf of the best interests of America’s children.”
Future practice challenges
“We have seen the start of a regulatory avalanche with PQRI and electronic health record implementation,” Dr. Ellis said in his address. “Now we face an even greater avalanche with health care reform – electronic prescribing, maintenance of certification, creation of health care registries, formation of health exchanges. The AOA will continue to stand up for our patients.
“Because of reform there will now be 32 million Americans who previously had no health insurance and no access to health care,” he continued. “With the well published shortage of physicians and ophthalmologists in the next few years, it will be up to optometry to cover the eye health care needs of America in the future. More importantly, it will be imperative that ODs in every state be allowed to practice to the fullest scope of their training.”
Dr. Brooks noted in his presidential report to the House of Delegates that as of March 25, optometrists and ophthalmologists are considered equals in the delivery of care in the VA system. “Medicine doesn’t like this and wants to do everything to convince everyone to believe otherwise,” he said. “Medicine has aimed a national campaign to roll back the patient care privileges of nearly 600 VA optometrists, and we are responding to this. No effort is being spared in Washington.”