Managed Care

3 Ways I Moved Past Managed Care Limitations to Build a Practice with 57% Annual Growth

The front desk of Dr. Vanek’s practice. A few key actions helped her new practice thrive despite the pressures placed upon it by managed care.

By Jessica Vanek, OD

May 11, 2022

Managed care can put a crimp on the growth of a practice’s profitability, limiting reimbursements and sometimes requiring offices to use specified products and optical labs.

Here are a few things I do to thrive–building a cold-start practice with 57 percent annual growth–despite the pressures placed upon on modern independent practices by managed care plans.

Get Picky About the Insurance Plans You Accept
When I opened my practice in October 2018, I accepted three vision care plans, and at this point, I am down to accepting one. I chose to do this because it is difficult to be profitable off vision care plans, unless you are seeing a significant number of patients throughout the day.

I started by dropping the plans that affected the fewest patients. This allowed my staff to ease into the change and become comfortable answering questions about my decision. I use Anagram, a technology that enables my office to help facilitate out-of-network reimbursements for patients. Doing this allowed us to retain some of those patients. We submit the out-of-network claim on the patient’s behalf, and the vision care plan reimburses them directly.

Drastically reducing the number of vision plans I accept benefits patients because it allows me to spend more time with them answering all of their questions and addressing all of their needs. I even have an extra few minutes to give my stamp of approval or opinion on frames they have selected or are considering. The additional time I am able to spend with each patient means that I can earn more money seeing fewer patients.

Sign On With Vendors that Support Independent Optometry
I am intentional about the vendors I decide to work with. I align only with businesses that support me and don’t compete with me. For this reason, I only carry independent frame lines. If you can buy a frame online, you will not find it in my optical.

This focus on independent products aids me in offering exceptional customer service. It is easy to offer excellent customer service because I know my reps, which is often easier to do when working with a smaller company. With that personal vendor relationship comes faith that I can count on the rep and company to stand with me in providing the patient with a superior product and a high level of service.

A smaller, independent company, in which I can personally get to know the people behind the brand, helps me to believe in the quality of the product I am selling. I can stand behind these products and sell them with confidence. Patients get excited about “Made in the USA” frames, along with those from Italy and Spain, countries with a reputation for glamorous fashion products.

In addition, I signed on with an independent lab, which has provided my practice with outstanding products and reliable customer service. I know glasses will be ready for patients when I tell them they will be ready, and they will be made well.

Build Services that Are Not Covered By Insurance
It is also beneficial to offer services that are not covered by insurance. For example, when I first opened my practice, I knew for sure that I was going to invest in an OCT. I opened my doors with the Maestro and offered testing via this “wellness screener” as an out-of-pocket expense of $35 to all my patients. The instrument gives me invaluable data and allows me to establish a baseline to monitor my patients’ eyes more closely over the years.

I am currently looking into other out-of-pocket services I can offer. There are many great avenues for cash-pay services ranging from vision therapy to dry eye treatments to aesthetic optometry. It is important to look at your practice demographics, launching new services that will appeal to your patients, and that they will find value in.

Jessica Vanek, OD, is the owner of eyes inc. in Millsboro, Del. To contact her:


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