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By ROB Editors
In recent years, the harmful impact of concussions has gotten increased attention. Concussion, along with conditions like stroke, can benefit from neuro-rehabilitation in the care of an optometrist. In addition, more practices are finding ways of optimizing the connection between the brain and vision to ease eye strain and even help delay dementia.
Here is what a few ROB contributors told us about building these services in their practices, along with insights on how these vital services can be put within reach of more people with patient financing via the CareCredit credit card.
Neuro-Rehabilitation Is a Natural Addition of VT & Sports Vision Services
Vision therapy is most often though of in relation to children. However, those who have suffered a traumatic brain injury, stroke, or other condition with neurological impact, can benefit from vision therapy.
As Miki Lyn Zilnicki, OD, FCOVD, and Jessica Licausi, OD, FAAO, FCOVD, built their vision therapy-focused practice, they found neuro-rehabilitation a natural fit. The local healthcare community surrounding their Riverhead, N.Y., practice also noticed. “Our services have caught the eye (pun intended!) of our medical community; specifically our local neurology group, pediatricians, a neuro-ophthalmologist and a concussion group. Having them as our primary referral sources gives patients a vote of confidence in our skill level and the services we provide. We foresee this more unique model of practicing becoming the sustainable future of optometry,” they told ROB.
For Vittorio Mena, OD, MS, neuro-rehabilitation goes hand-in-hand with the work he already does with athletes. The more he has learned about the connection between the brain and vision in recent years, the more it has reinforced the importance for him of services like neuro-rehabilitation that help athletes recover from injuries such as a concussions. “The difference between an athlete and an elite athlete is that slight edge they have over their opponent. In sports it is all about split second decision-making. When the eyes and the brain are aligned, and are able to react as quickly as possible, a win can suddenly become possible. An athlete with subpar vision will often be hindered from reaching the next level in their sport,” he said.
Neuro-rehabilitation services often come with a hefty out-of-pocket cost for the patient. Drs. Zilnicki and Licausi have found that offering patient financing via the CareCredit credit card helps both patients and the practice.
“In other medical fields, patients pay out-of-pocket for specialty services, and optometry can be no different! You must become comfortable navigating conversations with patients about cost when the insurance option is taken out of the equation. This can be especially challenging during a public crisis like the pandemic,” they said. “Offering the CareCredit credit card allows us to frame patient perception. If we don’t accept their insurance, we at least can show patients we are on their side when we offer options for them to make our services as affordable as possible. Using the higher end of our past CareCredit utilization of 15 percent of vision therapy patient population, and our average vision therapy program cost, offering CareCredit accounts for approximately $27,000 per year in vision therapy revenue.”
Address Eye Misalignment & Digital Eye Fatigue
For many patients, eye strain with accompanying headaches is a huge current challenge, with use of electronic devices continuing to increase.
Contoured prism glasses from Neurolens has provided a solution to many of these patients, and a huge practice-builder for optometrists. Rick E. Peterson, OD, added Neurolens technology to his practice to better diagnose and treat binocular vision problems. “Our clinic treats many focusing problems in adults and children, and we have been prescribing prism daily for over 15 years. The Neurolens Measurement Device—combined with the neurolenses with contoured prism technology—enables our practices to simplify sophisticated prescriptions consistently,” he said.
Along with easing symptoms like the headaches that can arise from digital eye fatigue, Neurolens glasses have helped patients with neurological issues. “We have even seen an improvement in patients who have previously suffered severe diabetic changes, stroke and other neurological disorders after they started wearing Neurolenses,” Dr. Peterson said.
The positive impact on patients is accompanied by a huge boost to practice profitability, as Neurolens glasses are not covered by patient insurance, creating a revenue stream free from the low managed care reimbursements. A study performed in the offices of Gary Lovcik, OD, demonstrated an 18 percent increase in gross profit and a more than 31 percent increase in net profit for his practice after adopting Neurolens technology. This result is amazing, especially given that Dr. Lovcik’s practice is 85 percent managed care.
Matthew Ward, OD, also finds Neurolens a great benefit to his patients and profitability. In his practice, patient financing via the CareCredit credit card allows more patients to access this life-changing technology. “Neurolens, which improves the lives of patients with eye misalignment, eye strain and headaches, is another technology that is revolutionizing our care,” Dr. Ward told ROB. He considers Neurolens an essential part of the specialized cash-pay medical eyecare services he offers, an area of his practice experiencing significant growth in profitability. In 2020, he said his practice billed around $100,000 just in exams.
Patient financing gives more people the ability to say yes to out-of-pocket services that improve their quality of life. “CareCredit gives patients a feeling of relief when my staff and I explain how, if approved for a CareCredit card, they can use it to finance payment of the out-of-pocket services I have prescribed,” Dr. Ward said.
Measure Cognitive Function As It Relates to Vision
Another area where the connection between the brain and vision is enabling growth of services for optometrists is the monitoring of brain function as we age. The connection between loss of vision and cognitive decline was shown in a recent study highlighted by the National Institute of Health’s National Institute on Aging.
A new technology, Cognivue, is allowing doctors to measure cognition through vision. Cognivue Thrive utilizes a patented technology, Adaptive Psychophysics, to accurately measure people’s ability to receive, process and respond to their visual world, Solomon Gould, OD, MBA, shared with ROB. The Adaptive Psychophysics technology permits anyone to experience the technology regardless of their vision and/or motor skills. Cognivue uses the patient responses during this specific, five-minute, self-administered test to dynamically change and adapt the test to determine their thresholds (best achievable scores) or failure points. The technology objectively detects the stimulus that was captured and identified by the brain, and in so doing, is able to differentiate between stimuli and describe the magnitude or nature of the difference.
“We can now not only help patients see, but we can also measure how well they process what they are seeing. Additionally, we can use this information to help our patients preserve their cognitive vitality and their ability to process what they are seeing. The reality is that we look with our eyes, but we see with our brain. I foresee this soon becoming the standard of care. The eyes and the brain are interconnected in so many ways, and they rely on one another for longevity and vitality,” said Dr. Gould.
Dr. Gould used the Cognivue Thrive with over 700 patients last year. “As with any new practice technology, I have tracked its performance along the way using various key performance indicators (KPIs). My new patient ratio, an indication of growth and referrals, has increased 5 percent on average each month. From when we first implemented the technology, my collections per full-time equivalent (FTE), an indication of staff productivity, has increased by $4,000. My revenue per patient, an indication of operational efficiency, has increased by $120. Lastly, this technology has yielded a generous 10.5 percent return on investment (ROI). It has also helped increase our patient retention and compliance with consistent, annual visits,” Dr. Gould said.
The ability for optometrists to measure visual performance, and then tie it to cognition, offers the potential to provide products and services for patients that can help them enjoy a much better live as they age, retaining greater vitality. As many of these products and services will likely require out-of-pocket payment, practices that offer the option to pay via financing through use of the CareCredit credit card will come out on top. They will be able to monitor and improve patient cognition while impressively growing profitability.