~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~
I share this photo with our members for many reasons. As a past president of the Pennsylvania Optometric Association, I wanted to point out an advocacy meeting for optometry that occurred while most of our members were seeing patients on March 27, 2013. Drs. Paul Lobby (left) and Greg Caldwell (right), volunteers for POA’s Third Party Center, met Dr. Paul Kaplan (middle), the vice president of strategy and integration of PCMH and ACO for Highmark Blue Cross Blue Shield.
During this meeting we discussed the role of optometry in PCMHs and ACOs; the role of optometry in management of chronic diseases, such as diabetes and glaucoma, and resulting HEDIS numbers; optometry’s role in the early detection of systemic diseases, such as diabetes, hypertension and other vascular disease, autoimmune diseases with ocular manifestations, stroke, etc.; the cost savings and quality outcomes produced by optometrists; and electronic exchange of patient health information.
We felt the meeting was productive and successful as Dr. Kaplan clearly understood the breadth and depth of optometrists’ scope of practice, and realizes optometry will need to be a part of integrated delivery systems in order to facilitate proper continuity of care, care coordination and care management. He mentioned that doctors who choose to be part of integrated health care teams (PCMHs and ACOs) will be expected to practice to the highest level of his or her license. Doctors included will already have the means to participate and will have demonstrated cost effectiveness and quality outcomes.
Sharing this photo is my way of alerting optometrists that these new integrated delivery and payment systems are currently forming. It’s not about debating whether they will work or not work and the positives and negatives of the new systems. The Pennsylvania Optometric Association and American Optometric Association are working with the stakeholders, including payers and ACO leaders, to ensure that our members will be included and have access to patients within these new delivery models and, at the same time, be well-positioned and equipped to deliver the cost-effective quality care that optometry has proven it delivers – the type of care being demanded by new market forces under healthcare reform. Much work will need to be done at the local level by local optometrists, most likely with the leadership of the PCMH or ACO. Tool kits are being developed by AOA to help at the national, state and local level.
More information will be provided by the state affiliates and AOA, but please be aware that these delivery systems may already be developing in your area. I encourage each of you to become aware and get engaged locally in these innovative initiatives.
For the Love of Optometry,
Greg A. Caldwell, O.A., F.A.A.O.
Chair, POA Third Party Center
