BLOG: Be part of essential wellness programs

The signature aspect of the Affordable Care Act is the list of essential benefits that are required for the health care exchange. These benefits, however, are moving beyond the marketplace of the exchange programs and becoming the standard for all health care products. These benefits are a big step away from the traditional insurance-based programs that require sickness or injury to make a “claim” and toward health maintenance programs that focus on prevention, wellness and health.

The element that is most often touted as optometry’s program is number 10, which requires pediatric services, including vision care. Although this is an important element, as it establishes optometry as an essential member of the primary care team, I continue to look to element number nine, preventive, wellness and chronic disease management, as optometry’s pathway to mainstream health care.

This September, I had my first revelation about this element while doing some research. I penned the blog, “Do you provide preventive health care?” to open this topic for discussion. Dialogue after this post has spawned several state associations to review the scope of optometry and open discussions with health plans. Today, I want to suggest a more “grass roots” strategy for optometrists in their local towns and communities.

One of the key themes of element nine is that of wellness. This term is batted around by so many that it is often ignored as a hollow platitude. In fact, it is the substantive difference between health insurance and managed health care.

A 2012 study by ADP found that 44% of midsized companies offered wellness programs as part of their benefit package. Although these programs may be expensive, a report released by RAND in 2014 found that for every dollar that a company spent in a chronic disease management program, the company saved $3.78 in health care expense.

So, how can optometry get involved in wellness programs? Most companies that embrace wellness programs include health screening and health education programs in the workplace. These programs are often annual events, and employees attend these during lunch breaks or other designated times that move the employees away from their daily duties. As such, they are well attended.

Optometrists have much to offer at a health fair. We can provide a number of high-tech screenings that may include simple visual acuity, visual field and IOP measurements to more sophisticated testing such as autofluorescence for diabetes or dark adaptation for macular degeneration. One of the most effective screenings that I have witnessed was a simple fundus photo with a short review with the optometrist and a take-home picture. The line for this station was the largest at the fair.

In addition to screening procedures, the opportunity for eye and vision health education is dramatic. Many of the employees at a health fair are not the typical refractive patients that we see regularly in our offices. People without refractive error know very little about their eyes or vision and the services offered by an optometrist. This is an opportunity to educate people about the eye and vision problems related to chronic systemic health problems such as hypertension, diabetes and obesity.

We can provide information about the eye-related effects of good nutrition, diet and supplements. We can highlight visual comfort, computer vision syndrome and vision-related work productivity. We can discuss and provide literature on the damaging effects of blue light on sleep, productivity and long-term eye health. Dr. Gary Morgan offers a wealth of information on this topic right here in his blue light blog for Healio.com/Optometry as well as in his lecture series.

In addition to the wellness services provided by optometrists, our industry has wealth of new products to enhance vision and visual comfort. These companies produce volumes of literature and patient education flyers that are readily available for distribution. They spend large amounts of money on television and print media to the general public that is largely ignored. Employees attending health fairs are seeking information about their health and wellness and are in a perfect position to be receptive to our message.

Active participation at annual company screenings and health fairs provides the opportunity to get out the message that optometrists believe that health and wellness affect the long-term performance of our eyes and vision and that optometric eye care promotes health and wellness. This message not only goes to the employees, but the sponsoring employers and the health plans will look to the optometrist as an essential part of the team for a comprehensive wellness programs.

The bottom-line tenets of health care reform are captured in essential element number nine of the Affordable Care Act: preventive, wellness and chronic disease management. These tenets are also at the core of the optometric profession. Because we get so focused on refraction and vision correction, we often lose sight of the bigger picture. Likewise, health plans, employers and the public view us solely as vision providers. It is time for us to reform our practices, reform our image and get in tune with the opportunity related to the sweeping changes of health care reform.

References:

ADP. More midsized companies adopt employee wellness programs to help reduce rising healthcare costs. http://www.adp.com/media/press-releases/2012-press-releases/more-midsized-companies-adopt-employee-wellness-programs-to-help-reduce-rising-healthcare-costs.aspx. Posted November 29, 2012. Accessed November 6, 2015.

Hussey PS, et al. Continuity and the costs of care for chronic disease. http://www.rand.org/pubs/external_publications/EP51779.html. Posted May 2014. Accessed November 6, 2015.