Eyeworld

January 2011 World View Integrated eyecare: Is this the right fit for your practice in 2011? A s I look out my window, 20 inches of new snow has just fallen on the ground. It is truly a winter wonderland (except for the the Mall of America Dome that just collapsed). Nonetheless, I would like to take this opportunity to wish you and your family a happy holiday season—a year of good health, happiness and hope; not only for you but also for your practice. What can we expect 2011 to bring? While none of us know for sure it has been said that the best way to predict the future is to create it. In this respect we do know certain predictors, which should help guide our decisions. 2011 will see the first year of baby-boomers becoming 65 years of age and hence Medicare beneficiaries which will extend into 2029 (approximately 80 million lives). The baby boomer generation has higher resources and expecta- tions than any generation in our history. Those over age 65 will double in population between now and 2030 as the U.S. population continues to grow by 25 million persons/decade. Furthermore, those age 65 and older make twice as many physician visits as those under 65. Addition- ally, as we all know the current healthcare payment strategy is unsustainable. While we averted a 23% cut in Medicare payments for 2011 we will be faced with the same problem with an even larger cut facing us one year from now. In 1993 we spent about $3000 per capita on all categories of health care. It is more than $8000 this year and is estimated to reach over $12,000 per person by 2015. Finally, we also know that the ophthalmology workforce (and physician workforce in general) is changing dramatically. Medical school enrollment has been flat to decreasing over the last 20 years after doubling from 1960–1980. 250,000 active physicians are now over 55 and the number retiring each year is rising rapidly. The federal government forecasts a shortage of at least 55,000 physician FTEs by 2020. Certainly it looks as if we are poised for the "perfect storm": increased population, decreased reimburse- ment and a decreased physician workforce. Time to throw in the towel and add to the decrease in physician workforce? Hardly, consider instead the healthcare oppor- tunity. We are living in an aging population with those over the age of 65 growing at twice the rate of those under 65. Technology advances like presbyopia correcting IOLs and laser cataract technology feed right into the consumerism exemplified by the baby boomers that desire improved quality of life. Lastly, the escalating costs have been a catalyst for regulations allowing for patient shared billing and those very baby boomers that desire life improvements from therapies are the same group who are willing and able to pay for it. Still, what strategies need to be employed to see this increase in our patient population? Previous editions of EyeWorld have dealt in depth with the former opportunities: this edition will deal with the last. The "Integrated Eyecare Delivery System" model has been employed by many practices over the years. However, the first time I heard this name applied to the idea was by Richard Lindstrom M.D. in 2007 when he de- scribed the model that characterized the way in which his practice conducted busi- ness. The concept very simply is the integration of all the Ophthalmology "O" caregivers/personnel. Ophthalmologists, Optometrists, Ophthalmic technicians, Op- ticians, and Ophthalmic administrative executives working together within a prac- tice to provide a model for efficient, high tech, high touch, cost effective care for patients. While some of the concepts discussed will be provocative and controversial to some and perhaps take you out of your comfort zone the reality of the perfect storm discussed above cannot be ignored. I have practiced within an integrated sys- tem for nearly a decade and have publically advocated for it. ASCRS has developed an Integrated Eyecare Delivery task force to determine ways to promulgate informa- tion about this model and give guidance how to best incorporate the system into ex- isting practice models. The information contained herein is one such attempt. Additionally, there will be courses and symposia at the ASCRS annual meeting. Be sure to look for them and make it a part of your annual meeting educational experi- ence. In the meantime I hope these articles will stimulate your thinking as you con- sider your options for the future of your practice. As always I encourage and chal- lenge you to help us make your magazine better by contributing your ideas and suggestions. Letters to the editor on any of the topics we discuss are encouraged. I look forward to hearing from you Happy New Year! Stephen Lane MD Medical Editor, EyeWorld Chair, Integrated Eyecare Delivery Task Force, ASCRS Publisher Donald R. Long dlong@eyeworld.org Editorial Editor Erem Latif elatif@eyeworld.org EyeWorld Staff Writers Faith Hayden faith@eyeworld.org Jena Passut jena@eyeworld.org Production Graphic Designer Julio Guerrero — jguerrero@eyeworld.org Production Assistant Karen Salerni — ksalerni@eyeworld.org Contributing Editors Vanessa Caceres — Lakeland, Florida Michelle Dalton — Reading, Pennsylvania Rich Daly Arlington, Virginia Enette Ngoei Singapore Matt Young Malaysia Senior Contributing Editor Maxine Lipner — Nyack, New York Advertising Sales ASCRSMedia 4000 Legato Road Suite 700 Fairfax, VA 22033 703-591-2220 • fax: 703-273-2963 eyeworld@eyeworld.org • www.eyeworld.org Advertising Sales Managers Jeff Brownstein — jbrownstein@eyeworld.org 703-788-5745 Paul Zelin — pzelin@eyeworld.org 703-383-5729 Classified Sales, Production Manager Cathy Stern — cstern@eyeworld.org 703-591-2220 EyeWorld Special Projects and Events Jessica Donohoe — jdonohoe@eyeworld.org 703-591-2220 Special Projects Editor Stacy Majewicz — smajewicz@eyeworld.org ASCRS Publisher: EYEWORLD (ISSN 1089-0084) is published monthly by ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; telephone 703-591-2220; fax 703-273-2963. Printed in the USA. Editorial Offices: EYEWORLDNews Service, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; toll-free 800-451-1339, 703-591-2220; fax 703-273-2963; e-mail eyeworld@eyeworld.org. Advertising Offices: ASCRSMedia, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; toll-free 800-451-1339, 703-591-2220; fax 703-273-2963; e-mail eyeworld@eyeworld.org. Copyright 2006, ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003. All rights reserved. No part of this publication may be reproduced without written permission from the publisher. Letters to the editor and other unsolicited material are assumed intended for publication and are subject to editorial review and acceptance. Subscriptions: Requests should be addressed to the publisher. Annual subscription prices: Individual: 1 year, $120; 2 years, $220; 3 years, $320. Institutional: 1 year, $250; 2 years, $330; 3 years, $425. Foreign: 1 year, $240, 2 years $470, 3 years, $700. 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POSTMASTER: Send change of address to EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033 Periodical postage paid at Fairfax, VA 22033 and at additional mailing offices. The ideas and opinions expressed in EYEWORLDdo not necessarily reflect those of the editors, publisher or its advertisers. P U B L I S H I N G   S T A F F January 2011 Volume 16 • No. 1 EW NEWS & OPINION 8 A S C R S The official publication of the American Society of Cataract & Refractive Surgery

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