Article Date: 5/1/2002

Practice Pulse: Tips, Trends & News You Can Use

'Haggling' Likely to Increase
By Bob Levoy, O.D., Roslyn, N.Y.K 

"Haggling With Health Care Providers About Their Prices Likely To Increase Sharply As Out-Of-Pocket Costs Rise" is the headline of a recent report from Harris Interactive, a worldwide market research and consulting firm.

The report indicates that as healthcare costs have risen, a sizeable minority of the public has been talking to healthcare providers to try to negotiate lower bills.

Looking at the numbers

For example, 17% have talked to a pharmacist in the last 12 months to pay a lower price; 13% have done the same with physicians; 12% with dentists and 10% with hospitals. How successful were they? "Approximately half of those who tried to negotiate a lower price report they did so successfully," the report reads.

"Our new data," the report adds, "strongly suggest that rising out-of-pocket costs are likely to result in much more consumer negotiation over healthcare bills and prices over the next few years." (sic).

More common than you think

Another article entitled "Medical Care: Can We Talk Price?" appeared in the February 2, 2002 Wall Street Journal. "In small but growing numbers," it reports, "Americans are taking an innovative approach to controlling health-care costs: They're haggling with their doctors."

What can you do about it?

What's the best way to deal with attempts at haggling if they occur in your practice? "Be firm. Don't give in." That's the consensus of optometrists with whom I've talked. It devalues your services. It also devalues you.

Some patients who haggle about fees/prices are just "testing the water." They've heard these stories and think to themselves, "What have I got to lose?"

Don't be a pushover

The danger of giving in: If word gets around that you'll reduce your fees or prices if someone merely asks you, it will surely increase the number of times you're asked to do so. And the more times you say yes, the more of a dent it will make in your year-end profitability.

Important exceptions: Hardship cases may warrant special consideration. Reducing or perhaps waiving professional fees for such patients is both appropriate and commendable.

This new Web site invites you to send in your practice pearls for cataract co-management. You're also asked to send in digital images or video clips of your most interesting cases. wishes to become an online exchange and virtual encyclopedia for the optometric community to share the best and latest ways to approach simple or difficult situations in cataract co-management.

Summit IT Launches Software Program

Leading information technology company Summit IT recently launched the software application HIPAAnswers, designed to help healthcare workers assess, track and and perform other tasks toward compliance with the Health Insurance Portability and Accountability Act (HIPAA).

The software provides suggestions and advice for users, according to Scott Thiele, CEO of Summit IT. "Much as off-the-shelf tax preparation software guides you through your taxes, HIPAAnswers walks organizations through the entire compliance process in five easy steps."

The software is best for small- to medium-sized group practices. Pricing starts at $5,000, but discounts are available.

1-Day Acuvue Lenses Benefit Allergic Patients

The FDA recently approved Vistakon's request to revise Acuvue Soft Contact Lenses' labeling to reflect the benefit for allergic patients.

According to the new labeling the lenses, when worn on a daily disposable basis, may improve comfort for patients with mild allergic itching during lens wear. The labeling also states that clinical research has demonstrated that Acuvue lenses may boost comfort for two out of three patients with allergies during lens wear.

The bilateral, randomized crossover study was conducted with 128 self-classified allergy sufferers over a period of 2 months in various parts of the United States.


Next January, Orlando will host a new national contact lens meeting for eyecare professionals. The Contact Lens and Eyecare Symposium (CLES), sponsored by the Contact Lens Institute, will combine the annual meetings of the Contact Lens Association of Opthalmologists (CLAO) and the Contact Lens Society of America (CLSA) and will offer continuing education as well as exhibits.

For more information, send an e-mail to

Vistakon Ads Target Presbyopic Patients

Vistakon is launching a series of print advertisements and sales tools to promote the benefits of Acuvue Bifocal Contact Lenses for patients with presbyopia. The ads will run throughout the year in a variety of professional publications. The campaign offers successful fitting techniques for the lenses and recommendations for prescribing lenses to presbyopic patients.

Refractive Surgery Okay

According to the Washington Post, the U.S. military has lifted its ban on refractive surgery for military personnel. Until 2 years ago, anyone who had undergone refractive surgery was disqualified from service because of concern about possible damage to the eyes.

The Department of Defense reviewed research that disproved the claims of damage and the military is now encouraging soldiers to undergo the procedure. Freeing these soldiers from having to deal with contact lenses and spectacles in difficult climatic and combat conditions is a big plus -- in fact, Congress has approved $15 million dollars for the Walter Reed Warfighter Refractive Eye Surgery Program.



Con-Cise names director of r&d. Con-Cise Contact Lens Co. recently announced the appointment of Robert Mandell, O.D., Ph.D. as director of the company's Research and Development.


Akorn receives patent for dye. Akorn received a U.S. patent for methods of diagnosis and treatment of abnormal vasculature using fluorescent dye angiography and dry enhanced photocoagulation. The company says that the dye, called indocyanine green (ICG), could be used in the diagnosis and treatment of choroidal neovascularization (CNV) associated with age-related macular degeneration. The dye would identify abnormal vasculatures and target a laser to stop the blood flow that feeds them.

Rodenstock restructures. Rodenstock North America will consolidate all administration, manufacturing and research-and-development operations for its frame and lens businesses within its Columbus, Ohio, facility by late summer.

The Columbus site currently houses Rodenstock NA's automated lens making and will become the company's corporate headquarters after its Alpharetta facility closes on August 2.

Two companies join to help ECPs. SOLA Optical and Eyefinity have entered into a long-term alliance to provide eyecare professionals (ECPs) with product information, dispensing advice and continuing education. Both companies intend to use the Internet to provide ECPs with diagnostic solutions and patient retention tools, while simplifying material acquisition.

Wants market leadership by 2003

The Cooper Companies, parent of CooperVision, recently set a goal of achieving "global market leadership" in contact lens business by next year.

Company CEO, A. Thomas Bender, predicts that the worldwide contact lens market would grow by the high single digits for the next 3 years and then by double digits toward the end of the decade.

Change of Mind Leaves More Blind

With the National Institutes of Health's estimate that 1.7 million elderly Americans, or 5% of the total population over 65 years of age have some degree of vision loss caused by age-related macular degeneration (AMD), you'd think we'd see more efforts to help AMD sufferers. And there was hope of getting care to more people -- until recently.

The American Association of People with Disabilities (AAPD), the American Council of the Blind (ACB), the Alliance for Aging Research and the American Macular Degeneration Foundation recently announced their determination to fight the March 29 decision of the Centers for Medicare and Medicaid Services (CMS) to deny national Medicare coverage of ocular photodynamic therapy with verteporfin (Visudyne) for the treatment of age-related macular degeneration (AMD) with occult lesions.

In 2001, the CMS issued a national coverage decision memorandum announcing it's intention to cover OPT with verteporfin for AMD patients with occult lesions. At that time, the CMS estimated that roughly 35,000 to 70,000 Medicare beneficiaries would benefit from this decision. But by reversing its original decision, the CMS has denied beneficiaries access to the only effective treatment available for AMD. "The harm done by this decision is sufficiently severe to warrant continued advocacy aimed at reversing this tragic decision," said Charles Crawford, executive director of the ACB.

Chip Goehring, president of the Board of Trustees of the American Macular Degeneration Foundation, said, "This decision means that thousands of Medicare beneficiaries will needlessly lose their sight . . . Our fear that treatment only will be available to seniors who can afford it has suddenly become a reality."

AAPD President and CEO Andrew J. Imparato echoes the same sentiment. "Now only the wealthy will have access to this sight-saving treatment for AMD."

Web Site to Allow Self Vision Testing

According to an article in Asia Biz Tech, Tokyo eyeglass retailer Vision Optic Co., Ltd., plans to launch an e-commerce Web site enabling consumers to perform their own eye tests and purchase eyeglasses over the Internet.

The site, called Dokodemo Megane (glasses wherever you are), is scheduled to go live this month and will provide the onscreen eye test. Consumers can choose from 10,000 frames after the eye test provides their lens power. They'll also be able to see how the frame will look on the "virtual fitting" page. The article stated that preliminary tests show the site to have an 85% accuracy rate. What next?


Daily wear keratoconus lens gets marketing clearance

Ocu-Ease Optical Products of Pinole, Calif. has received FDA market clearance to manufacture and distribute its daily wear Ocu-Flex 38 polymacon contact lens for keratonconic patients.

Diagnostic trial sets are now available and consist of four lenses in the 8.60/14.5 base curve/diameter geometry. Each lens is labeled A, B, C or D, depending on the sagittal depth of the lens. The cone diameter can vary, creating varying degrees of sagittal depth (approximately 5.0 mm diameter) for beginning or incipient keratoconus, while Cone\alignment Series D has the largest sagittal depth of approximately 8.0mm diameter for advanced Keratoconus Powers from -3.00 to -20.00D in 0.25D increment steps are available.

For additional fitting information or to order a set, contact customer service at 800-521-8984.


Optometric Management, Issue: May 2002