Tips4EyeDocs Weekend Edition for 2012Jan07-08 – No.20 – Why is VSP looking to foreign markets?

At home or at the office, you see the headlines scream “VSP [Vision Service Plan] looks to expand in foreign markets” (Robertson, 2011). You get that lump in your throat or that knot in your stomach; images flash before your eyes. You imagine that your practice, founded with your sweat and tears, is back to square one when you first opened. How should we view these headlines? How does it relate to my practice?

First, practically every large company in the United States derives a significant proportion of its revenues from overseas commerce, some nearly one half (Center for Public Integrity, 2011). Therefore, it is natural for VSP to look elsewhere for new revenue opportunities especially since its domestic revenue will likely shrink dramatically if standalone vision plans are not included in health insurance exchanges. For VSP, it is a wise business move, one that I believe has been in the offing for many years.

While it is difficult to estimate or even guess what the impact might be, it is certain that VSP will lose more large employers, a significant proportion of its business. However, there is no reason to panic yet. By 2014, if VSP can have in place at least $200 million a year in annual revenue from foreign operations, then VSP is likely to survive whatever misfortune it experiences from the effect of the ACA 2010 legislation.

Two factors may ameliorate the effects health care reform. Luckily, the Obama Administration will each state will have latitude in defining how standalone vision plans can be integrated into a health insurance exchange. Additionally, smaller employers will still maintain VSP but it is likely that VSP referrals will drop precipitously. As business owners, doctors should prepare now for alternate revenue sources. Don’t be caught on the sidelines or unawares. I posted about alternative revenue sources (Hom, 2012). Check that out and stardt planning.

1. Robertson, K (2011) “VSP looks to expand in foreign markets”. Sacramento Business Journal, Decmeber 30, 2011. Available online with registration at
2. Center for Public Integrity (2011) (Available online at
3. Hom, Richard (2012) “Alternative Practice Revenue? GrandRounds4ODs Web Site (Available online at


1. James Johnson advises that “positive” content will get more “likes” , but negative will get more comments. Which do you want to receive for your Facebook page?

2. If you’re not involved in social media of some kind, then it’s possible that you are placing yourself at a disadvantage to your competitors. Spotted on Twitter via: @MWilliamsDayton: 79% of the Global Fortune 100 are using at least 1 of the social media elements considered Facebook, Twitter, YouTube and corporate blogs.


Overview (my take home message): There seems to be a correlation between quality of life issues with vision and total quality of life and severity of stroke. It’s therefore possible to use quality of life vision issues as a proxy for stroke rehabilitation objectives.
George S, Hayes A, Chen C, Crotty M.”Are vision-specific quality of life questionnaires important in assessing rehabilitation for patients with hemianopia post stroke?” Top Stroke Rehabil. 2011 Jul-Aug;18(4):394-401.
Source: Flinders University and Repatriation General Hospital, Adelaide, South Australia, Australia.

OBJECTIVE: To explore the relationship between disability and functional measures with vision-specific quality of life (QoL) measures for people with hemianopia and stroke.

METHOD: The Behavioral Inattention Test (BIT) and the Mayo-Portland Adaptability Inventory (MPAI) were compared with scores on 2 vision-specific QoL measures, the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and Veteran Low Vision Visual Function Questionnaire (VA LV VFQ-48). Setting: Rehabilitation hospitals in Adelaide, South Australia.

PARTICIPANTS: Stroke patients (n = 24) with homonymous hemianopia.

RESULTS: Most of the BIT and MPAI scores were significantly associated with the NEI VFQ-25 and VA LV VFQ-48 scores. Behavioral test scores of the BIT and the MPAI total score correlated with more aspects of the QoL measures than the other components of the BIT and the MPAI.

CONCLUSION: BIT and MPAI measure constructs associated with QoL for people with hemianopia following stroke. Vision-specific QoL questionnaires can complement the functional instruments by identifying the domains of difficulty, based on the instrument’s subscale, that can guide rehabilitation therapists to address the person’s deficit.

PMID: 21914605 [PubMed – indexed for MEDLINE]

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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