Tips4EyeDocs Daily for 12/16/2011 – VSP’s Business Model + Grand Rounds Brain Teaser


The Business Model of VSP and its competitors

  1. Private practice optometry is inherently inefficient and costly. To fuel this inefficiency, reimbursements and extra charges must be sufficiently flexible enough to reward panel doctors. However, this is untenable considering that EyeMed and Davis, for instance, have uniform stores with uniform policies and uniform costs throughout their retail distribution channels.
  2. In California, private optometrists lamented the staff OD/dedicated optical model of the Kaiser HMO system where almost 50-75% of the patients may be covered; leaving little for the remaining for the private practice optometrists.
  3. To leverage the “premium” label of private optometrists, VSP created the Primary Care program to differentiate itself from the rest of the field. In this way, the “value” of VSP isn’t restricted to refraction and materials. Instead, by broadening into eye health care, employers can potentially lower their costs by this tie in. However, for some optometrists, this is antithetical to the medical model where a well-eye visit is to be billed to vision and a medical eye problem should be billed to a medical plan.
  4. Because VSP only operates as a vision benefits/insurance plan, their requirement for an infrastructure for each state’s compliance makes it bureaucratic and bloated. Regulatory compliance drives this and because of how deeply it is involved in so many areas, I don’t see how VSP can trim the staff without hurting compliance.
  5. Can the cost of a private practice optometrist encounter be lessened or reduced in any way to allow for more flexible pricing? That will be key. More later.


  1. Four reasons why you should not operate first on children with strabismus (spotted on Twitter via @Visionhelpers)
  2. Facebook is now testing coupon banners, Coupons have always been an easy way to track performance of ad campaigns because of the audit backwards that is available.
  1. Top Tips for Creating a Customer Satisfaction Survey, (excerpted)
    1. Were you satisfied with your purchase?
    2. If service was involved, did they come at the specified time? Were they polite and efficient?
    3. If delivery was involved, were you satisfied with the way it was handled?
    4. Was there anything that you did not like about the purchase?
    5. Do you plan to buy from us again?
    6. Are you willing to recommend us?
    7. Do you have any suggestions as to how we can make it an even better experience for you?


A middle aged male presents to your office without any acute eye problems and was only referred to your office because a friend had noticed that his right eye’s vision was poor. He appears not to be in distress. However, his skin appears roughened and even pale and he has mild labored breathing while walking to the chair, unassisted. He is Hand motion vision in the right eye (pinhole with no improvement and 20/20- vision in the left. If the history and the entering acuities and this retinal picture were all that you have, what would your course of action and working diagnoses.


About Richard Hom OD, MPA

Dr. Hom holds Doctor of Optometry and Masters in Public Administration degrees and practices family eye care and consults on public policy, health information technology and program evaluation.
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