Eyeworld

96 | EYEWORLD | MARCH 2020 I NSIDE THE PRACTICE by Ellen Stodola Editorial Co-Director new glaucoma procedures. Currently he offers iStent inject (Glaukos), but he plans to begin offering both the ABiC procedure (Ellex) and the Kahook Dual Blade (New World Medical). "We have patients who will benefit from these," she said, explaining that Dr. Burns had held off on offering new glaucoma options because he was already performing the iStent, but these new technologies could help his pseudophakic glaucoma patients and patients who previously received an iStent but needed lower pressures. The practice recently purchased a laser for the office. While this will cost more money upfront, Ms. Greenwell said it will make more sense in the long run. Previously, the practice rented a laser, which cost $50–75 per case. It also limited the days and number of uses since the laser was not owned by the practice. The practice will be able to perform selec- tive laser trabeculoplasty, YAG capsulotomy, and YAG iridotomy with this new purchase. Ms. Greenwell said being able to perform a YAG capsulotomy quickly in the office will likely help increase satisfaction in premium lens patients. Finally, Ms. Greenwell said the practice is evaluating its marketing budget. They looked at what they were spending, what was working, and what wasn't working. "We're a very busy practice, so we still want to market to keep our name out there, but we didn't need all of the magazine and newspaper ads that we were pur- chasing," she said. Eye Care Physicians & Surgeons, where Orval Gilmore, COE, serves as an administra- tor, is looking at numerous ways to adjust. He said they have talked about the cut in cataract surgery along with other carrier issues in the region. For example, Oregon instituted a Cor- porate Activity Tax, effective Jan. 1, 2020, which assesses a gross receipts tax. "This will be a significant tax for us with no revenue to offset," Mr. Gilmore said. One goal of the practice is to increase its premium lens percentage. "Our current premi- um lens percentage is collectively just over 8% of all cataracts," Mr. Gilmore said. "We per- formed just under 4,200 cataracts last year, and 341 of those had premium lenses associated W ith the 2020 cut to cataract surgery reimbursement, many practices around the country are considering their options for increasing revenue and decreasing costs. Administrators from three practices spoke to EyeWorld about how they plan to act. Kimbel Hunter said one way their prac- tice intends to increase revenue is by offering more premium lenses. Currently, the practice offers two options, but it plans to move to four different premium lenses. He added that many patients are asking for this technology. "Most patients want multifocals, and there are some huge improvements in options," he said. Additionally, the practice is looking to in- crease efficiency by purchasing a different plat- form for electronic health records (EHR). The new system confirms the coding requirements, provides documentation, and offers a fax or di- rect messaging option for referrals. "The system reduces training time and provides a consistent way to work up patients," he said. Piedmont Eye Center also plans to par- ticipate in additional clinical trials. "This helps to offset the reduction in reimbursements and keep our overhead low," Mr. Hunter said. Nicki Greenwell, COA, said her practice, led by Frank Burns, MD, put together a plan in December 2019 to address reimbursement cuts. They realized they had not raised their refrac- tion fees in a long time. The practice reached out to other practices in the area and looked at online message boards to see what others in the area were charging. "We were one of the lowest prices," she said, so they bumped it up. They also increased the practice's premium lens prices, which Ms. Greenwell said hadn't happened since they first introduced the lenses. "We've also implemented ORA [Alcon], so we needed to increase them," she said. The pric- es were increased by about $50 per case, and she said this will likely bring in quite a bit of revenue because the practice's conversion rate is about 40–45%. Ms. Greenwell said Dr. Burns, the sole oph- thalmologist at the practice, plans to offer two Adjusting to reimbursement cuts: Plans to increase revenue and decrease costs About the sources Orval Gilmore, COE Eye Care Physicians & Surgeons Salem, Oregon Nicki Greenwell, COA Middletown Eye Care Louisville, Kentucky Kimbel Hunter Piedmont Eye Center Lynchburg, Virginia

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