Managed Eye Care Intrusions in the Doctor-Patient Relationship

eye check
June 3, 2021
James Ashford

As surgeries, tests and even visits with eye doctors have risen in price, patients have had to continually turn to insurance companies to be able to afford eye care. Insurance companies have decided that managed eye care is the best way to control costs.

But how has managed care impacted the relationship between doctors and patients? Are there alternatives to help patients afford eye care without having the insurance company drive decisions? Vision Care Direct of Oklahoma is the middle ground that you, as an optometrist in Tulsa, are looking for for your patients.

Managed care rundown

According to Medicaid.gov, managed care is a type of insurance set up to manage the cost of health care, how often and where services are available, and the quality of said services. Insurers use managed care to ensure that providers offer services that align with accepted standards and costs of care.

This might seem to be in a patient’s best interests. However, there are some aspects of managed eye care that can become a problem for them. For example, it may limit:

  • How often patients can see a doctor or provider every year.
  • What providers they can see (“in-network providers”).
  • What services a patient can get in the first place.

Plus, insurance has to approve some services in advance before they cover them.

There are a number of different managed care plan designs. Health maintenance organizations (HMOs) tend to more tightly restrict which providers and services a patient can receive. But they are usually the least expensive upfront (lower premiums, lower cost-sharing). Preferred provider organizations (PPOs) allow a lot more flexibility and freedom of choice but tend to have higher premiums, deductibles and out-of-pocket maximums.

Changes in managed care over time

Managed care came into “vogue” in the 1980s when health care costs began to accelerate. Insurance companies developed HMOs to limit costs and make sure that quality was being maintained. However, many people balked at the tight restrictions on provider networks and services that HMOs imposed.

HMOs later morphed into looser point-of-service (POS) and PPO plans, which allowed patients to see non-network providers at higher costs. With health care becoming increasingly costly, it appears that the pendulum is swinging back to HMOs, but with looser requirements than we had in the past.

Insurance and the doctor-patient relationship

In all types of insurance plan designs, the insurance company can act as the intermediary between the patient and their doctor. Insurers can decide which services to cover and which ones the patient will have to pay the full cost for.

This can mean that doctors and patients end up with services that aren’t exactly what the patient needs because they can’t afford the full cost of a non-covered service. In this instance, the insurer retains the power in the doctor-patient relationship, which can be frustrating for all involved.

Vision Care Direct offers an alternative to managed eye care

Vision Care Direct is not an insurance company. Instead, we are a pre-
paid vision plan that eye doctors own. We focus on the health of your patients’ eyes, not on making a profit. So, we offer many different plans at many price points. All of our plans include member savings on comprehensive eye exams. Our members can choose their own eye doctor in Oklahoma, rather than having to adhere to a strict network.

We provide offers for lenses and frames as well and include the features that many patients want, such as UV protection and no-line progressive lenses. Because we aren’t an insurance company or a managed eye care plan, you and your patients have the flexibility to choose the services and supplies that patients want and need. That is the Vision Care Direct difference!

Managed care has helped to keep eye care more affordable. However, it comes with some limitations that impact the patient-doctor relationship. Vision Care Direct provides a great alternative for patients and optometrists in Tulsa OK. We help make eye care more affordable, without the limitations of managed care. To learn more about how we can help you and your patients, contact us today.

Not sure where to get started with recommending self-funded plans? Vision Care Direct of Oklahoma is pre-paid plan provider with and extensive of specialists who deliver eye care in Tulsa and nationwide with excellent value for employers and plan recipients.

Find out more about our self-funded plans and other flexible options.

GET AN INSTANT PROPOSAL

Have a group in mind that you’d like us to quote? It’s simple! Fill out the online questionnaire and we’ll prepare a personalized quote.

Let's Talk About You

Let us know if you have any questions or if you’d like to chat.

Popular blog posts

Contacts for Kids and Classroom Accommodations

Contacts for Kids and Classroom Accommodations

Children and teens can benefit from wearing contact lenses, especially if they practice sports or feel self-conscious about their appearance. However, contacts for kids can lead to hygiene-related challenges in the classroom. As a teacher, you can educate your...

Top Trends Shaping the U.S. Optometry Industry

Top Trends Shaping the U.S. Optometry Industry

Technology is transforming the U.S. optometry industry at a dizzying pace. For optometrists, staying abreast of the latest trends is more important than ever for offering quality care, optimizing revenues, and improving patient satisfaction. This blog post will review...

How Technology Can Help Students With Vision Impairments

How Technology Can Help Students With Vision Impairments

Students with blindness or vision impairments can encounter a number of challenges in a traditional classroom environment. Not being able to access printed material, videos, images, and other visual content is a common barrier to their learning experience. Technology...

Digital Marketing Strategies Tailored for Vision Care Plan Brokers

Digital Marketing Strategies Tailored for Vision Care Plan Brokers

Vision care brokers need to be creative to reach their target audience in today's crowded market. Finding the right prospects and getting their attention in a way that resonates with their needs is an ever-present quest. This requires balancing the usual methods of...

Blue Light Glasses for Digital Eye Strain: Tips for Office Workers

Blue Light Glasses for Digital Eye Strain: Tips for Office Workers

As an employer, it’s important to create a safe and comfortable work environment. With employees spending a significant portion of their workday staring at screens, it's important to consider blue light exposure and how it can affect eye health. Below, we’ll examine...

Understanding the Pros and Cons of Hard and Soft Contact Lenses

Understanding the Pros and Cons of Hard and Soft Contact Lenses

More patients than ever opt for contact lenses as a discreet and more natural alternative to eyeglasses. However, navigating the different types of contact lenses can feel confusing. We created the following guide to help you compare soft and hard contact lenses....

Evolving Vision Coverage: Exploring New Trends in Eye Care Benefits

Evolving Vision Coverage: Exploring New Trends in Eye Care Benefits

Keeping up with the latest vision coverage trends will help brokers adapt to the changing needs of their target audience. Let's take a closer look at what consumers expect from vision insurance plans in Oklahoma and how plan providers are expanding their offerings....

Choosing the Right Blue Light Glasses: A Buyer’s Guide

Choosing the Right Blue Light Glasses: A Buyer’s Guide

Digital screens are an integral part of the day for most American workers and students, translating into high exposure to blue light. If you've been dealing with headaches, eyestrain, and other symptoms, it's time to look into getting blue-light glasses. Read on to...

Understanding Contact Lenses: How Do They Correct Vision?

Understanding Contact Lenses: How Do They Correct Vision?

Contact lenses are a popular alternative to eyeglasses for those with refractive vision errors. In the following blog post, we'll explore the benefits of wearing contacts, how contact lenses work, and the different types of lenses available. Understanding Contact...

VCD Teacher Scholarship Success Story

VCD Teacher Scholarship Success Story

Students spend as many as seven hours a day in a classroom. This environment is crucial to learning and student well-being. Teachers are using creative solutions to transform their classrooms into welcoming environments that are conducive to academic success, but...

Senior Vision Care: The Importance of Specialized Vision Plans

Senior Vision Care: The Importance of Specialized Vision Plans

Your health needs change with age, including your eye health. For seniors, keeping up with annual eye exams and addressing eye health issues early is crucial. Here is how vision plans can make eye health plans more accessible for seniors and others. Why Seniors Need...

Patient Relationship Management in Optometry

Patient Relationship Management in Optometry

Building strong patient relationships results in better experiences and outcomes for eye health patients. As an optometrist, you can grow your optometry practice by taking a proactive approach to patient relationship management and implementing proven strategies to...

Teacher Resource Guide to Vision Health for Students

Teacher Resource Guide to Vision Health for Students

6 MIN. READ We often associate decreasing vision with aging, but eye health issues are common in school-age children. As an educator, you can make a difference by familiarizing yourself with common symptoms caused by vision problems. You can also connect families to...

Tips for Including Eye Breaks and Visual Exercises in the Classroom

Tips for Including Eye Breaks and Visual Exercises in the Classroom

4 MIN. READ Healthy vision among students is a top priority for teachers and a lofty, commendable goal. This blog explores the ease and benefits of incorporating eye breaks and visual exercises into your classroom routine. Implementing these techniques helps Oklahoma...

Preventing, Treating, and Managing Childhood Myopia

Preventing, Treating, and Managing Childhood Myopia

Childhood myopia, or nearsightedness, is a common eye health condition that makes far-away objects appear blurry to children. Experts believe it affects as many as 20% of students. While symptoms can vary, myopia often causes issues for school-age children with...

5 Ways to Enhance Your Optometric Practice in 2023

5 Ways to Enhance Your Optometric Practice in 2023

Practice growth is a priority for many Oklahoma vision care providers. Although the average provider's income in Oklahoma is close to $57/hour, the regional income lags behind other parts of the country. Staying ahead of the curve and continuously improving your...

Vision Plans Are a Valuable Employee Benefit Solution

Vision Plans Are a Valuable Employee Benefit Solution

As an employer, you may wonder, “Are vision plans worth it?” Yes, vision plans are valuable employee-benefit solutions that can benefit both your business and your employees. We will explain the different types of vision plans, how they can impact your employees, and...

Smart Contact Lenses Are Coming Soon – Here’s How to Get Them

Smart Contact Lenses Are Coming Soon – Here’s How to Get Them

Smart contact lenses are still in the early stages of development, but they hold enormous potential for the future. They can monitor and manage chronic health conditions, provide real-time feedback during athletic training, or even enhance our daily lives with...

Your Employees Will Love You for Offering Vision Screening

Your Employees Will Love You for Offering Vision Screening

An eye exam is a crucial aspect of maintaining good eye health. It involves a series of tests that assess a person's visual acuity, depth perception, color vision, and eye alignment. The benefits of vision exams are numerous, including early detection of eye diseases,...

How Employers Can Help in the Fight Against Vision Loss

How Employers Can Help in the Fight Against Vision Loss

According to the Centers for Disease Control and Prevention, the economic cost of major vision problems is projected to increase to $373 billion by 2050. Vision-related issues are estimated to impact 20 million Americans. This means that the likelihood that your...

Customer Care and Personalized Vision Plan Access

Customer Care and Personalized Vision Plan Access

For individuals and families in Oklahoma and nationwide, eye care health is a significant concern. Brokers play an essential role by helping customers navigate their insurance options and advocating for their best care. Customer care and personalized vision plan...

Why You Should Care About the Optometrist/Eye Doctor Face-Off

Why You Should Care About the Optometrist/Eye Doctor Face-Off

In 2022, California Gov. Gavin Newsom vetoed a measure giving optometrists in the Golden State the legal authority to perform laser eye surgery and some other advanced procedures. It was a victory for ophthalmologists in the ongoing eye doctor or optometrist debate....

Are Blue Light Protection Glasses Worth it?

Are Blue Light Protection Glasses Worth it?

With the advancement of digital devices and the amount of time we now spend in front of them, many people are dealing with eyestrain and fatigue. As a result, blue light protection glasses have become increasingly popular as a way to diminish this stress, and they...

Effective Eye Care for Older Adults Includes These Five Things

Effective Eye Care for Older Adults Includes These Five Things

Since 1900, the percentage of Americans over 65 has almost quadrupled. Yet, only a handful of these individuals live in institutional settings. Therefore, access to quality healthcare, especially eye care, is an issue. That’s especially true since these providers must...

How important are vision care benefits to employees?

How important are vision care benefits to employees?

Eye health is essential to our overall wellness, and employee vision plans are an increasingly popular option for employers. However, do employees understand the unique benefits of these plans and why they’re so vital to our health? Employers should understand what...

What Is Genetic Ophthalmology and What Does It Mean for Eye Health?

What Is Genetic Ophthalmology and What Does It Mean for Eye Health?

Genetic ophthalmology (GO) is an emerging field that could provide more effective treatment for genetic eye diseases such as glaucoma. However, GO also raises some serious concerns that should be addressed as this technology progresses. What is Genetic Ophthalmology?...

Top 5 KPIs to Track When Assessing Plan Performance and Satisfaction

Top 5 KPIs to Track When Assessing Plan Performance and Satisfaction

As a broker, you need to maintain a diverse product portfolio so you can help companies build packages adapted to their needs and budgets. Tracking these 5 key performance indicators when comparing plans will help you better identify the ones that are more likely to...

How to Get Discounts on Frames and Discontinued Lines

How to Get Discounts on Frames and Discontinued Lines

Eyewear and contact lenses are vital to the optometry field. Keeping this in mind, doctors should be aware of the purchase costs of these goods to boost their revenue. Frame reps make commissions on sales, so they’re incentivized to sell as much as possible, but are...

Designing a Modern Optometry Practice

Designing a Modern Optometry Practice

One question that optometrists should consider is, “When patients walk into your optometry office, how do you want them to feel?” Naturally, patients desire comfortable, welcoming, and modern environments, as these characteristics put them at ease. Therefore,...

November 2022: Native American Heritage Month

November 2022: Native American Heritage Month

Native American Heritage Month celebrates a rich culture and educates people about issues unique to the Native American community. It’s an opportunity to draw attention to health issues that disproportionately affect Native Americans. It’s a group that is at higher...

Top 3 Reasons to Work with Smaller Plan Providers

Top 3 Reasons to Work with Smaller Plan Providers

In the healthcare benefits industry, brokers are essential in helping small businesses find plans. Smaller companies might not have the resources or experience to do thorough research into the options available. Fortunately, there are brokers who understand that...

3 Signs It’s Time to Review and Upgrade Your Benefits Package

3 Signs It’s Time to Review and Upgrade Your Benefits Package

A routine inventory of your benefits package can tell you where you may be able to reduce spending and, equally importantly, can also ensure that it continues to meet the needs of employees. That’s why Vision Care Direct of Oklahoma recommends reviewing your benefits...

October 2022: Breast Cancer Awareness Month

October 2022: Breast Cancer Awareness Month

It’s Breast Cancer Awareness Month. You might be wondering about the link with vision health. The truth is that a simple eye exam can sometimes detect early signs of cancer. Breast cancer can result in metastasis. When cancer cells break away from the main tumor, they...

Understanding the Ins and Outs of the Vision Plans You Accept

Understanding the Ins and Outs of the Vision Plans You Accept

For eye doctors in Tulsa OK, as well as other states, a regular review of the plans you’re currently accepting, and their ins and outs, is something you should be doing. By understanding the vision plans you accept, you can better identify how you are paid and the...

Top Strategies for Helping Plan Providers Meet Their Goals

Top Strategies for Helping Plan Providers Meet Their Goals

When trying to reduce healthcare spending, employers who offer employee benefits in the state of Oklahoma, as well as anywhere else, should be aware of one fact: there are options available that don’t increase the costs to employees via high deductibles. As a broker,...

Rethinking How You Offer Value Part 3: Build Digital Connections

Rethinking How You Offer Value Part 3: Build Digital Connections

The pandemic has sped up the digital transformation. Many professionals are embracing the virtual world because they realize connections matter. We've been sharing tips about how to rethink the way you offer value as a broker who offers plans accepted by an...

eGuide: Top 10 Ways Vision Care Direct Makes a Broker’s Job Easier

eGuide: Top 10 Ways Vision Care Direct Makes a Broker’s Job Easier

Top 10 Ways eGuide - Vision Care Direct Makes a Broker’s Job EasierOur eGuide is chocked full of ways Vision Care Direct can simplify working with a vision plan.  When you quote a vision plan certainly you are looking at the price and size of the network, and so is...

Search blog posts