/ /

  • linkedin
  • Increase Font
  • Sharebar

    How to decide when to drop a crappy plan

    I recently received an email from my friend and colleague Mike Rothschild, OD, from Carrolton, GA. Mike is a member of the Optometry Times Editorial Advisory Board, authors our practice management department, and heads up Leadership OD, a doctor-to-doctor consulting service. A little-known fact: Mike and I started out practicing in the same small northwest Georgia town. Eventually we both left—I to teach, he to build a mega-practice from scratch in his wife’s hometown.

    More from Dr. Bowling: Are optometrists really happy?

    In his email, Mike tackles the ongoing question in all of eye care: should I accept (or drop or keep taking) That Crappy Insurance (TCI)? Anyone in optometric practice knows exactly which ones they are. These plans don’t pay enough for the services we provide and place restrictions on what service our patients may have. So we constantly struggle with the “keep or drop” decision, unsure of what to do and worry about the consequences of our decision.

    Mike explained that in its simplest form, the decision to be in or out of a given vision plan depends on two factors (does the vision plan pay well, and is the practice schedule full enough?) and can be decided with a simple four-quadrant grid.

    This grid yields a keep/drop decision in its simplest form. Other factors, such as the plan’s penetrance rate in your service area and an associated medical plan are other factors to consider. Still, it is a useful device when evaluating the benefit of a vision plan to your practice. I’ve seen practices that take any and every vision plan on the market, thinking that a warm body in the chair is better than none at all, while on the other hand, I’ve never heard an OD say he regretted dropping (insert your favorite TCI here).

    More from Dr. Bowling: Oral antibiotics not effective in MGD?

    We are all burdened with vision care plans, yet we must prevent our practices from becoming shackled to those that seem to be racing to absolute bargain-basement reimbursements. As Mike Rothschild warns, “If you find yourself cutting corners so you can take more plans, consider that you might be doing a disservice to the people who are willing to choose you over their plan.” Yes, Virginia, they are out there, and they are the ones we all strive to grace our doors.

    Ernie Bowling, OD, MS, FAAO
    Dr. Ernie Bowling is Chief Optometric Editor of Optometry Times. He received his Doctor of Optometry and Master of Science in ...

    1 Comment

    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • I think your "keep" and "drop" are off here. I'd rather see a doc drop a "bad" reimbursement plan if the schedule is full than drop a good one. And if the schedule is not full, keep your higher paying plans, no?

    Optometry Times A/V