The Contact Lens Event of the Year

BY JOSEPH T. BARR, O.D., M.S., EDITOR
JAN. 1997

What do you believe was the most important contact lens event in 1996? Was it Wesley Jessen's acquisition of Pilkington Barnes Hind, or Summit Technology's purchase of Lens Express? Was it any of the court rulings on class action suits or on collusion between practitioners, organizations and contact lens companies?

How about the slow growth of PRK procedures in the United States (an estimated 75,000 eyes this past year compared to a projected 350,000)? Or was the event of the year the slow, steady growth of managed care? Maybe it was the large states permitting O.D.s limited use of medicine or an Idaho judge ruling against PRK performed by O.D.s.

Did any of these events have a profound impact on the future of contact lenses?

IT'S MANAGED CARE

Anytime a group of contact lens practitioners got together this past year, the topic that dominated the conversation was managed care. The conversations took many forms, and no wonder. The term 'managed care' seems to describe simple discounting, HMOs, PPOs, capitation or any other forms of dealing or fee-setting that apply these days.

And it's starting to apply to most patients seen by most contact lens practitioners most of the time. Even as horror stories about poor care and questionable ethics in HMOs mount, managed health care and low reimbursement vision care advances relentlessly. Why? Because of the oversupply and maldistribution of eye doctors? Because of greedy insurance company executives? Remember when the doctors were considered the greedy ones? Now, O.D. and M.D. gross income is being forced down but their expenses are not. Certainly, eyecare doctors are frustrated by the competition and by the fact that only about one percent of managed care dollars goes to vision care.

As reimbursement for eye health care goes down and vision care plans force lower comprehensive eye exam fees on optometrists (who do most of the contact lens care for most contact lens patients most of the time), both O.D.s and M.D.s are 're-engineering' care and reassessing the value of the contact lens patient to the vision care practice. Doctors often argue that quality is not a part of the rules forced upon them by third parties while the third parties say they have quality control. Many often agree that the new definition of quality is simply no or low complaint rates. All things considered, many practitioners hope third parties will stay out of contact lenses. Meanwhile, contact lens manufacturers are watching the scene unfold while trying to decide if third-party intervention in contact lenses is good or bad for business.

THE OUTLOOK

No one would predict great growth of the contact lens patient base in the United States, but they would predict slow growth worldwide. Our teen-agers want contact lenses and are sheltered from refractive surgery at this time. They will counteract the loss of contact lens wearers to the less-than-optimal capability to manage presbyopia and the aged dry eye with contact lenses.

We will find a way to deal with managed care and to provide contact lenses to all who need them. In this and future issues of Contact Lens Spectrum, we'll show you what's new in the profession and the industry so you can make contact lens care all it can be despite managed care pressures in 1997. CLS