Monday, November 4, 2013

Dollars and Cents of POA Membership

By Donna Buraczewski, O.D.
POA Immediate Past President

Have you ever considered dropping your membership because of the amount of dues or heard colleagues say they cannot afford the price of membership? Then this post -- the first of several analyzing the benefits of membership and why all optometrists in Pennsylvania should be members -- is for you.

I have been a member of the POA for 30 years. I recently received a memento letter opener with the POA logo as a recognition award. If I was a “number person," I could tell you exactly how much that membership has “cost” me. But really, it's more important to know how much more the membership has earned me. 

Let’s start by looking at history. When I graduated in 1983, optometrists were not reimbursed for medical services by Medicare and most other third party payers. Thanks to the efforts of the POA and AOA, we are now reimbursed for those services.

So when I began my solo private practice in 1986, I was able to bill Medicare and be reimbursed for my services. But how many medical services could I provide since I was not allowed to prescribe therapeutic agents? In 1996, the POA passed legislation so Pennsylvania optometrists could not only detect eye diseases, but also treat them.  Again due to the efforts of my fellow members, these privileges were expanded in  2002.

Now how much did you bill in Medicare services last year? What percentage of your income was from the treatment of eye diseases, including glaucoma? Last week alone, I billed 39% of my gross revenue to medical third party payers. 

How many of you have received incentive payments from CMS for EHR implementation? Did you know that optometry was not initially included for reimbursement? The AOA stepped in and changed that, and optometrists have now received a substantial amount in payments. Depending how many Medicare services you provide, each optometrist had the opportunity to receive $44,000 in incentive payments. That more than covers my 30 years of dues.

Do you receive income from the Pennsylvania Medicaid system? Due to the efforts of the POA, optometrists and other providers in Pennsylvania are paid equally for the same services. Many optometrists also received reimbursements for past services.

How many children do you examine in your office? The AOA was instrumental in having pediatric eye care as an Essential Benefit of the Health Care Reform policy. Remember that when you examine a child in your office.

We sometimes forget that these privileges were not handed to us because some other policy maker thought it was a good idea. POA and AOA advocated on our behalf to be included in these elements of the health care system; individual doctors could not have achieved inclusion on our own. Furthermore, never forget that that these privileges could be removed at any time at the whim of another profession, payer or regulator. The only thing preventing a reversal is your AOA and POA.

Would the POA and AOA accomplish these successes even if I or you weren’t members? Maybe, but this type of constant vigilance and proactive advocacy require significant human resources, and a small pool of optometrists -- no matter how dedicated -- could not afford it on their own.

And imagine how much more we could accomplish if all optometrists in the state were members. Share this information with non-members and encourage them to become members today.

And THANK YOU for your membership.