October 2018

OPHTHALMOLOGY BUSINESS

Dry eye services rarely covered by insurance


by Randy Baldwin

Flexible financing can help pay for much-needed treatment

While the prevalence of dry eye increases and research continues to shed new light on the disease, the opportunities for ophthalmologists have never been greater, and the need is clearly there.
Patients of all ages experience dry eye symptoms, which can be caused by anything from excessive screen usage to eye surgery to medical conditions. For some patients, increased screen usage may be causing them to blink less, leading them to experience dry eye symptoms. Patients may also have dry eye after surgery or with certain medical conditions. With so many different causes, it’s no surprise patients of all ages are seeking treatment for dry eye disease.
However, it’s important to point out that despite being important to vision, comfort, quality of life, and surgical outcomes, most dry eye procedures aren’t fully covered by insurance.
Because many patients require lifelong treatment, dry eye services can be a financial burden to patients of all ages, which may decrease compliance with recommended treatments. When patients must buy prescriptions, pay for insurance copays and a premium IOL, and take time off of work, that is a big investment.
To allow patients to focus on getting the care they need, ophthalmologists must have processes and tools in place to help patients meet their financial obligations and to establish funding mechanisms that will benefit both the patient and their practice. For example, if patients know the cost of a procedure in advance, they might save for it or seek out financing options.

Offering bundled treatments

In the experience of Elizabeth Yeu, MD, Virginia Eye Consultants, Norfolk, Virginia, patients may balk at the very concept of dry eye treatment, making them less open to paying for a procedure. She and her colleagues handle this with a combination of education and financing.
“There is a polarizing concept inherent in paying for treatments that aren’t covered by insurance,” she said. “When we tell patients they have a disease but treatment isn’t covered, they naturally doubt the veracity of the treatment. They would rather use over-the-counter eye drops than pay for a doctor’s treatment. It is our task to explain the disease, along with our surgical and dry eye counselors. They’re very good at communicating not only out-of-pocket costs and financing options, but also the current state of dry eye treatment. They explain to patients that there has been a boom of discovery in the last 5–7 years, changing our understanding of dry eye disease and how we diagnose and treat it. Insurance has not caught up yet.”
The bundling of dry eye treatment with surgery at Virginia Eye Consultants appeals to all generations. Older patients might bundle treatment with cataract surgery, while millennials may combine dry eye treatment with LASIK financing.
“The cost of dry eye treatment is easy to roll into surgical costs for LASIK and premium cataract surgeries, and we offer some dry eye services at reduced costs when they are bundled with surgery,” Dr. Yeu said. “With 12–24 months of fair financing, patients appreciate that care is accessible to them. It also makes sense to offer it along with surgery, which has the potential to make them more symptomatic without dry eye treatment.”

Patient financing

The demand for patient financing exists. CareCredit (Costa Mesa, California) conducts research to learn more about how people purchase healthcare services and related products. According to a survey from CareCredit, 47% said they would have postponed or not moved forward with the complete recommendation from their doctor if the CareCredit credit card had not been available.1 Another CareCredit study revealed that 73% of cardholders would consider a financing option if they could receive medical treatment right away.2

Take-home message

To help remove financial barriers when it comes to dry eye care, financing plays an important role. All patients deserve the opportunity to decide for themselves which payment option is most convenient for them. Providing a way to fit dry eye care into their budget may encourage patients to get the recommended care they need. EW

References

1. Cardholder Engagement Study, Q4 2016
2. CareCredit Path To Purchase, 2016

Editors’ note: Mr. Baldwin is vice president of marketing, CareCredit. This article is intended to further the conversation started in EyeWorld’s December 2017 feature series “Survive or thrive: Preparing for changes in ophthalmology.”

Contact information

Lisa Siebert: lisa.siebert@stephens-adv.com

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