Health care reform prompts ODs, OMDs to focus on integrated eye care

Issue: June 2013

Experts predict that the aging population and implementation of the Affordable Care Act will result in millions of new patients seeking eye care, and two major ophthalmic organizations are taking steps to prepare their constituents.

Nearly concurrently, the American Society of Cataract and Refractive Surgery (ASCRS) held its first Integrated Ophthalmic Managed Eyecare Delivery (IOMED) track at the ASCRS annual meeting, and the American Optometric Association (AOA) announced the formation of an Integrated Eyecare Project Team.

Since July 2004, ASCRS has limited attendance at its annual meetings to optometrists who are employed by ophthalmologists or industry. In April 2012, the society created a new category of membership, welcoming optometrists employed by ASCRS-member board-certified ophthalmologists, industry, the military, universities or Veterans Administration hospitals.

The IOMED program was developed “to advance an eye care delivery model based on a synergistic collaboration between optometry and ophthalmology,” according to the organization.

“I was enthusiastic about how the program went,” IOMED Task Force Chair Stephen S. Lane, MD, told Primary Care Optometry News. “Participation was terrific. The program was excellent.” He noted that about 110 optometrists attended.

IOMED task force member Marlane J. Brown, OD, FAAO, told PCON, “It showed examples of what’s happening with integrated eye care right now. No politics were brought into the symposium.”

Afterwards, the task force met to discuss future educational endeavors and the possibility of their group becoming a formal ASCRS committee.

“But it’s not within the purview of the task force as to whether or not that should happen,” Lane said.

A group of independent, privately practicing optometrists who are interested in attending the ASCRS meeting were invited to share their feedback with the task force on-site.

Jack Schaeffer, OD, one of those five optometrists, told PCON, “We explained that we felt opening a meeting only to employed optometrists was a step backwards. While their intentions may have been good, if the IOMED task force aims to truly enhance the ability of doctors to give better care, there should be no exclusion for the majority of doctors who give that care.

“The AOA project team will be the official voice of optometry,” he continued. “We are just a group of doctors that’s concerned with this policy.”

Schaeffer said his group of about 30 optometrists sent a proposal to the ASCRS leadership.

“I believe they now understand how the majority of optometrists feel about this initiative and they will take a major step forward,” he added.

“We have a good idea of what they would like and they have a good idea of what we can and can’t do,” Lane said. “But there are things we might be able to cooperate on in the future. Those are decisions made in the executive committee and governing board of the ASCRS.”

Brown noted a sense of collaboration during the task force meeting.

“There are a lot bigger issues that need to be resolved,” she said. “Wouldn’t it be great if we could unify our professions and march into Washington together to make significant changes to help our practices, rather than spend our time and energy fighting each other?”

Meanwhile, the AOA project team is beginning its work by examining the specific facets of integrated care models.

“As we move into this new era of health care reform, it’s clear that integrated care and coordination of care will be critical to achieve greater efficiencies in the health care system,” AOA project team Chair Christopher J. Quinn, OD, said in an interview. “We want to take a broad perspective on how our professions can work together in an environment that’s mutually respectful of each profession, recognizing the skills and qualities that each profession brings to the patient care arena.

“We believe that the ASCRS and American Academy of Ophthalmology meetings should be open to all optometrists,” he continued. “If we’re working together there should be free flow of education and information. Restricting educational opportunities for professionals can never be in the best interest of improved patient care. But our perspective is broader than simply looking at educational opportunities afforded by ophthalmology meetings.”

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He said the project team will be looking at quality of care, efficiency and controlling costs.

“[The AOA’s project team] also wants to look at scope of practice issues – how do we work together while independently exercising clinical judgment that’s not dictated by either profession?” he said. “What’s a good ratio of primary care practitioners to surgical specialists that will result in efficient and high quality care?” – by Nancy Hemphill, ELS

Marlane J. Brown, OD, FAAO, can be reached at: mjbrown@mneye.com.
Stephen S. Lane, MD, can be reached at: sslane@associatedeyecare.com.
Christopher J. Quinn, OD, can be reached at: quinn@omnieyeservices.com.
Jack Schaeffer, OD, can be reached at: drschaeffer@schaeffereyecenter.com.