The truth about vision networks
Evaluating vision plan networks is not easy. Is the biggest always the best? Should you count the number of doctors or the number of locations? Is it important to consider the number of opticians, or can you just stick with counting optometrists and ophthalmologists? How about measuring big-box retailers against local family sole practitioners?
When it comes to determining best overall access and value, simply comparing access points alone can create significant challenges for your clients’ employees.
Networks should be carefully selected based on a variety of key criteria, including utilization, convenience, customer experience and how they meet the specific needs of their workforce.
Quality over quantity
It's not only about the number of providers in a network, but also the quality of care. For example, one network might only cover basic computerized refraction tests, while others include comprehensive eyes exams that are more likely to catch serious underlying conditions.
It’s also about how those providers’ products and services align with co-pays, benefits and the needs of the workforce. Most vision plans already offer a national network of providers, many with thousands of access points. Yet because these access points can vary widely in specialty, type and size, they may not always be right for an individual employer and their employees.
The American Optometric Association reports there are more than 37,000 doctors of optometry, students or assistants in the United States. They practice at retail chains, private practices and other retail access points. Private practices often operate more like traditional doctor's office and typically offer a higher level of personalized service. At an independent practice, the optometrist often works more closely with opticians to pair patients with the right products and service to maximize not only their vision, but to ensure their visual health and reduce risk for many catastrophic diseases. Retail chains often operate as two separate businesses with an independent doctor that conducts exams and a retail side that sells the eyewear.
For many clients, having an expanded network of thousands of providers solely for the sake of quantity may serve little value. Brokers will want to take a closer look at the network based on utilization, convenience, and customer service. Flexibility is important as well. Some vision carriers want to offer true convenience by empowering members to visit any provider they want without incurring significant out-of-network costs. So, it’s important to take that into consideration and choose a vision carrier that doesn’t heavily penalize your clients’ employees for going out-of-network and provides the best flexibility.
The Three ‘O’s: Opticians, Optometrists, Ophthalmologists
There is often confusion about the different types of eyecare providers. It’s important for brokers to understand the levels of care each provides so that your clients and their employees get what they need.
Opticians specialize in the fitting of glasses and other corrective lenses. They often work out of eye care centers, retail stores or joint practices. Many states require opticians to be licensed by the American Board of Opticianry before they are permitted to dispense corrective eyewear.
Optometrists or doctors of optometry (O.D.) offer comprehensive eye exams that are used to test patients for things like farsightedness, nearsightedness, eye injuries and diseases that can impact vision and health. They also remedy vision problems by prescribing contact lenses or eyeglasses, and can help with care before and after eye surgeries. When partnered with ophthalmologists, optometrists may also provide some medical care. Doctors of optometry must complete a four-year postgraduate degree program and be licensed by the National Board of Examiners in Optometry.
Ophthalmologists (Eye M.D.) are medical or osteopathic doctors who specialize in all aspects of eye care including diagnosis, management, and surgery of ocular diseases and disorders. The most common eye surgeries performed today are refractive and laser eye surgery, which includes any surgical procedure used to repair vision problems. Ophthalmologists are doctors who have completed at least 8 years of postgraduate medical training.
As a popular and permanent fix to some vision problems, LASIK surgery is growing globally at a rate of more than 5 percent per year, according to a recent report by Transparency Market Research.
While most vision plans don't fully cover refractive surgery, many do offer discounts on or allowances toward it with certain providers. And considering the growing demand for such procedures, it's worth selecting a plan that has a network of laser vision doctors.
Personalization is key
Brokers will want to look well beyond network numbers to find a plan that meets the needs of their clients’ and their employees.
This is especially important in today's diverse workforce. The AARP reports that by the year 2020, more than a quarter of the country's workforce will be over the age of 55, and the American Optometric Association says adults over the age of 60 are at much greater risk for issues like age-related macular degeneration and cataracts.
Meanwhile, the growing number of millennials in the workforce have their own eye care needs. Consider this: while 93 percent of millennials don't schedule visits to doctors, they are also enticed by vision coverage and likely to use it. Roughly 60 percent of millennials say that eyewear is a "fashion statement," nearly a same amount also need vision correction. For this younger generation, affordable access to designer frames can be especially important. Because this generation likes to purchase many things online – including eyewear – brokers should look for vision plans that allow their clients’ employees to purchase contacts and eyewear online with their insurance.
And while a good vision plan can help employees save hundreds of dollars on frames, it can also provide preventive care, that can help identify issues like diabetes and high blood pressure early, which can help improve productivity and control healthcare costs. When looking at vision networks, brokers should consider what their clients’ employees need and will use. Because bigger is not always better, it's best to evaluate plans based on utilization, convenience and customer service.
Consider offering VSP
VSP® Vision Care checks all the boxes and is constantly looking for new ways to enhance the patient experience and deliver the highest quality of care. With more members than any other provider, they have unique insight into what employees want most and can help build the right vision plan to drive utilization. They are also known for delivering great customer service, convenient access through a large variety of private practice, retail and online channels, and substantial savings on eye exams, eyewear and refractive eye surgery.
Visit sellvsp.com/breakthroughs to learn more about their latest offerings.