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The Affordable Care Act is knocking at your door
As we begin a new month for 2014, I have started to look for some changes in the landscape for optometric care. As the Affordable Care Act becomes operational, we, as primary care providers, should start to see some changes at the ground level. Just as you have to look very hard for the first signs of spring in February, you have to look hard for these changes in our practices, but they are out there.
The first change that I have seen is a significant uptick in the number of health plan applications that have landed on my desk. Some of these are vision plans, but a fair number are health plans, some that I have never even heard of. I have also received calls and emails about joining more health plans. It seems that I just published a piece in Primary Care Optometry News about how optometrists can become involved with medical plans, and now it seems that the plans are coming to us.
The second change that I have noted in the New Year is a significant uptick in patients hunting me down at various offices looking to schedule for medical eye care. It seems that my services are now covered by their health care plan, and they have been referred by other doctors, many of whom I have never met.
The third change is really dramatic, and one I almost missed as something related to the Affordable Care Act. I received an email from the chief of a large local hospital requesting my assistance in adding an optometry program to their outpatient clinic. This hospital already has a strong ophthalmology program with a national reputation, but now they want to add optometry services. In the same week, I got a call from a pediatric ophthalmologist also requesting assistance in adding an optometrist to one of his programs.
What can be happening out there? Many of my optometry colleagues have been telling me that all this health care reform was going to be the end of our profession, but suddenly we seem to be in high demand. If you have been following the news, this should not come as such a surprise.
First we heard from the American Optometric Association that the Affordable Care Act was going to include eye care for children as an essential benefit. This means that every child up to 19 years of age is covered for a comprehensive eye exam. These eye exams are one of the 10 new essential benefits in this health care law. The spin-off result of this change in the law is that optometry is suddenly an essential provider of health care services.
In 2013, “essential” was just a concept, but now in 2014 this is translating into numbers.
According to a National Journal article published Feb. 5: “A health care consulting firm estimates that the health law is directly responsible for as many as 1.8 million new Medicaid enrollees.”
In a Jan. 13 article in the New York Times: “Nearly 2.2 million people picked a health insurance plan through the exchanges established by the Affordable Care Act through Dec. 28. This is about 65% of the administration’s goal for this period. After a rocky start, enrollment picked up with more people signing up in December than in the first 2 months combined.”
That is 4 million people with new health care insurance that includes the essential benefits!
There are a number of things that optometrists should be doing to capture this new wave of patients and to assure your ongoing essential role. I have made many suggestions in this blog over the past 6 months, but here is a quick review:
- Enroll as a provider in as many health plans as are practical for your practice.
- Provide primary health care services for your patients, not just primary eye care.
- Communicate your findings to the other health care providers for each of your patients.
- Change to electronic medical records and use them to meet the standards of meaningful use.
- Expand your knowledge base in primary health care and medical eye care.
- Expand your medical services with new technology.
Many of us have made at least some of these changes and are ready to be essential. For those who have prepared, freshen up the batteries in your retinoscope; it is going to be a busy spring!