Earlier this week while attending the American Academy of Optometry meeting I wrote a blog posing the question, "How does optometry want to fit into the new healthcare landscape?" Much to my surprise, while many have had the opportunity to look at the entry, only one person responded - and that person did so in a personal email, not on the blog. Now that the meeting is over and I’m headed home I'm wondering why the silence? I think this is a discussion and debate that optometry and all the other health science professions need to have.
As the effects of the Affordable Care Act take hold on the American healthcare system the number of payment and payer options for our professions will unquestionably change. Today there are a myriad of payer and insurance companies. According to the experts I've talked to this almost certainly will change. In the (very near) future we will see a consolidation of insurance providers and payers much like we've seen in the American healthcare sector. We've already seen this happen to our airline industry. Remember when there was an Eastern, National, Pan Am, TWA, and Continental airline? Well, now there are only a few major carriers. We're going to see the same thing occur with health insurance carriers. Optometry, Audiology, Occupational Therapy, Speech, Language Pathology and the other health sciences must be agile in adapting to this new environment, otherwise they risk being "boxed out" by major carriers or worse.
In my humble opinion, one of the best ways to do this is to ensure we're all part of what will be an integrated system of healthcare providers who are aligned with Accountable Care Organizations, Patient Centric Medical Homes and Medical Neighborhoods and other entities that focus on the delivery of primary care, high quality and value. As I mentioned in my prior blog I believe this will require all the schools and colleges to work together to develop and teach our students how to best work within this new landscape. This includes business prowess but also must include in-depth discussions in policy and how to influence policies.
For optometry, I also believe the profession will need to continue its evolution as a primary care profession to include the management or co-management of common metabolic disorders such as diabetes, hypertension and hyperlipidemia. As our healthcare system focuses more on the public health, outcome data, access to care and cost, professions such as those were training need to become more involved in prevention and patient education. Smoking cessation, nutritional counseling, and lifestyle advice need to become integral parts of what we teach and ultimately integrate into our everyday practices.
There is a great deal to think about as we enter into this new chapter in healthcare delivery. I want us to be part of the discussion on what this looks like and not the recipient of what others develop for us. Complacency and sitting on the sidelines is not only an unacceptable course of action but can very well become a devastating behavior that leaves many health science professions subservient to others; something many have successfully worked very hard to avoid over the past 50 years.
It's time to be bold, creative and responsible. Educators, providers, researchers, industry and other important collaborators need to come together and have a very candid debate on how we all fit into this new healthcare landscape. We can choose to be spectators or players - Players determine the outcome of the game - spectators only can brood about the outcome. I want to play; I hope you do as well!