The OD/MD model is a growth opportunity for some ophthalmology practices. Is teaming up the right move for yours?
Complementary training and skills between ophthalmologists and optometrists can make for a great team, healthcare consultant Jill Maher, MA, COE told attendees at the 2016 ASCRS/ASOA annual meeting. It can also increase revenue, optimize your current overhead, and even boost your chances of benefiting from new value-based care initiatives, like MIPS. An integrated care model dovetails nicely with the goals of health care reform—lowering costs, increasing efficiency, and improving outcomes through coordination of care.
The relationship between MDs and ODs is steadily moving towards integrated eye care, and the fruit of this partnership is crystal clear, Paul C. Ajamian, OD told the Review of Optometry in a recent interview. “MDs working closely with ODs . . . are exposed first-hand to our training and clinical expertise. It doesn’t take long for them to see how working together can benefit their practice, and, simultaneously, our mutual patients,” he said.
Is an Optometrist Right for Your Practice?
ODs often see patients who have not been to a medical doctor in years, so an optometrist may be a good fit for practices that deal frequently with diabetes. In his interview, Dr. Ajamian envisions an optometrist who knows his patient over a long period of time and who is familiar with that patient’s vision and medical history. The long-term knowledge that the OD brings to the table can help the MD provide better, more targeted care.
Because ODs screen for glaucoma, they can offer a non-threatening diabetes screening for patients who may not otherwise come into a doctor’s office. ODs can “help with diabetic patients and screening for diabetic retinopathy because patients are waiting for hours to see a retina specialist and they need a screening first,” Maher says.
A Win-Win Partnership
Reimbursements continue to slide. Providing care is becoming more expensive, exerting downward pressure on optometrists struggling to grow their practice and their income. Partnership or employment in an MD practice means that an OD can likely provide more services to a similar number of patients, growing revenue with little new patient acquisition cost.
Employment within an MD practice could also fit the career goals of many ODs. Owning a practice requires financial investment and risk, business savvy, and a significant time commitment. Not every physician is prepared—or wants—to become a business owner.
The partnership can be a real win-win, Maher notes, providing optometrists with “a more diversified patient base, top-notch tech, more support from a large staff and MD resources, and better hours than a retail establishment.” Plus, in an MD/OD model, you can keep most medical referrals in house without worrying as much about compliance pitfalls like Stark. It also eliminates the common concern that the patient won’t return to the referring physician.
3 Things to Think About
Many factors go into the planning and allocation of resources involved with bringing on an optometrist, Maher explains. For example, you’ll need to credential the OD separately with Medicare and vision plans, and ensure your staff is aware of new coding protocols. You’ll also need to consider:
Clinical staff: You will probably want to wait and see what the patient flow is before determining if your optometrist will need her own technician, Maher advises. She suggests waiting until the OD is seeing three to four patients per hour, but for some ODs, you could go up to six.
Support staff: Do you have enough front office staff to process the additional patients per day a new OD will bring in? Can your billing staff efficiently process additional claims each day? If not, your practice won’t function efficiently and your patients, and profits, will suffer.
Space: Do you have enough lanes to accommodate the new OD without slowing down your current workflow? If not, can the OD generate enough revenue to make up for the diminished workflow efficiency?
Made the decision? Follow these tips to ensure a smooth transition for your recent hire—and your current staff.