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I WHAT OPHTHALMOLOGISTS SHOULD BE DOING TODAY N FOCUS 54 | EYEWORLD | OCTOBER 2019 by Vanessa Caceres EyeWorld Contributing Writer sider coming together with other local surgeons and pooling technicians and billing for the ASC, he added. 2. Build your premium IOL business By identifying patients who truly want and could visually benefit from premium IOLs, you can find a somewhat turn-key boost to your business. This tends to work well because informed patients nowadays often want educa- tion on their various options to improve their lifestyle. However, it does take some prep work. "Conversion from a standard lens to premi- um options does not happen by accident but instead through rigorous attention to detail and effective education of patients," Mr. Maller said. One key component: surgeon buy-in. "Once the surgeon is on board, successful implementation requires a significant invest- ment and commitment to training of staff," Mr. Maller said. Dr. Sheppard described a commitment to offering premium IOLs as changing the cul- ture at your practice so all clinical staff, from counselors to telephone operators to triage to techs and optometrists, are properly educated about the premium options—and the practice continually builds on that education as newer lenses come out. 3. Focus more on dry eye patients Dry eye patients have routinely been ignored or underappreciated, but that may be changing. Greater attention to dry eye patients is poten- tially a win-win for practices and patients. "I am a big advocate of capturing dry eye, especially for a practice with MDs and ODs," Dr. Lind- strom said. "Dry eye patients, in my opinion, should be captured just like glaucoma patients and seen every 3 to 12 months. With the point- of-service office tests available today and the therapeutic procedures, one could argue that a dry eye patient is even more beneficial to a practice than a glaucoma patient financially." If you have physician extenders such as optometrists or physician assistants, they can W ith medical reimbursements projected to decline, ophthalmic practices must take a closer look at ways to bring in new income. The good news? This may not be so hard. "Unlike other medical spe- cialties, ophthalmology has the unique oppor- tunity to charge patients for premium services. This is one of the most common and potential- ly attractive ways to boost revenue," said Bruce Maller. There are many directions that practices could potentially take to help grow business— some of them an easier fit than others. John Sheppard, MD, advises sticking with areas that are the most natural fit for cataract and refrac- tive surgeons versus extending your business too far into left field. Here are some practice-boosting ideas that physicians may want to consider to help grow their practice. 1. Open or co-own an ASC Opening an ASC is not as easy as snapping your fingers. It can be a long, drawn-out process, particularly in COPN (certificate of public need) states like Virginia. That said, if you have the right surgical volume and can invest some time and effort, it often pays off. One addi- tional benefit: Facility fee reimbursements are not likely to be cut like surgeon fees have been cut. Operating your own surgical center usually makes surgery and scheduling more efficient as well, Dr. Sheppard said. "This could be a good opportunity depend- ing on one's volume and the ability to secure ownership shares in an existing surgicenter on favorable terms," Mr. Maller said. Richard Lindstrom, MD, said that having around 500 to 600 surgical cases a year is usually enough to sustain a small OR ASC. If you get to 1,500 cases a year, that's often enough for two ORs, Dr. Sheppard said. You can build an ASC for use with other ophthalmic subspecialties such as retina and oculoplastics, Dr. Sheppard suggested. If your practice is not big enough to own an ASC, con- 6 ideas to boost your practice revenue stream At a glance • Ophthalmic practices must take a closer look at ways to grow business due to declining reimbursement. • An ASC can take a long time to develop, but many ophthalmol- ogists have found it pays off both financially and for better efficiencies. • Solid staff education can make conversion to premium IOLs or greater commitment to dry eye patients successful. • The addition of optometrists can help surgeons focus on what they do best. • Adding subspecialists to a practice can be a good clinical fit at some practices.

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