Regardless of practice mode or location, every optometrist monitors some preferred metrics to evaluate the health of his or her practice.  Just like measuring visual acuities or intraocular pressures, the wellness measures need to be monitored at baseline and then over time for trend analysis.  Businesses big and small have key points that they monitor to guide budgeting, expenditures, and key investments.

Beyond tracking the practice’s income and expenses, today’s optometrist is challenged to know the business inside and out because of the critical decisions that must be made about involvement in managed care programs.  From local HMOs to national vision plans to Medicare and Medicaid, doctors face the never-ending task of trying to decide how low their fees can go in order to participate.

Most optometrists accept some managed care patients; some take many.  Those that are employed by managed care systems have their take-home pay tied to volume of patients, RVU generation, or some other equation that requires attention to detail.  Independently employed doctors have a more challenging analysis and, frankly, don’t have any good tools to help them know the bottom line impact of managed care.

There are consultants who can help by applying their machine to the analysis process.  These advisors truly have the success of the practice at their core.  They have acquired knowledge from experience in the industry and they apply it as specifically as they can after getting to know their clients.  But like every optometrist they serve, they have biases and it is critical that the doctor has a clear view of the path that is desired when contracting with a consultant.

Vendors of equipment, software, and wholesale products also offer advice.  Their biases are even more angled, which is fine as long as the doctor has that understanding.  Ophthalmic companies derive revenue from helping optometrists make revenue, so it is not necessarily a negative to take advice from them.  They only do well if you do well, but you must tread carefully with their advice if it overstates their value to you.

Recent examples of this have arisen in the EHR industry.  In light of the money that will be available in 2011-2016 from the federal stimulus act, some software companies have made the potential maximum dollars available look like a lot more than is really available.  How?  Well, Medicare already pays physicians (and optometrists) a small bonus if they report PQRI codes on a consistent basis.  The theory is that with software, doctors will be more likely to do quality reporting and thus will qualify for the bonus payments.

The rub is that the bonuses are paid on top of Medicare payments for services rendered, currently as a 2% addition.  The maximum PQRI payment for a doctor is $5,000 in a year.  To receive those dollars, you would have to receive Medicare payment of $250,000, and unless your fee schedule is at the rock bottom that Medicare pays, you would probably have billed 50-100% more than that for the service rendered.

That’s not very likely, and thus it’s really a stretch for a software vendor to say that use of EHR will land you that extra $5,000 maximum.  How many doctors know that?  Not many.

For that reason, you have to pay attention to your own practice metrics in order to be sure that you make smart business decisions.  You have allies in the industry to help you, and choose them wisely and listen to what they say carefully.  But validate anything you hear — just like you do when your technician measures IOPs on your glaucoma patients.

In absence of your careful attention, decisions that you make for your practice could be unwise.  Why let the system play you?  Take the pulse of your practice more carefully than ever… today.