|
This is where we post the most recent
information and additions to our web site. Look here if you've
visited us before and want to know what's changed.
Vision Advantage is now the largest
provider-owned vision and
eye care product on the market. Sponsored by a national network of Regional Eye
Care Delivery Systems, this program is now active in 40 states.
The Edmonds Group welcomes
Max
Vision Care
to our family of eye care products. This is a fully insured
option for employer groups.
Vision Advantage has been chosen as the vision program
for the coalition of bargaining units at Michigan State University. The
program was tested on a six month trial by the Clerical and Technical Union and
received the "Thumbs Up" paving the way for the other nine Unions to
enroll in the program.
Vision Advantage is owned and operated in the state of Michigan by SEECOM, a
Regional Eyecare Delivery system consisting of optometrists and ophthalmologists
from across the state.
The Edmonds Group welcomes
Premier Vision
-a California based corporation in affiliation Premier Vision Services, LLC,
California liability company
Premier Vision holds the contract with Molina Healthcare for risk based eye
care. REDS Administration providers the actuary, claims,
data, and customer service for this contract.
The Edmonds Group has recently become involved in a project to
link our doctors to their patients through individual practice web
sites. PRIVwire Internet services is
actively recruiting eye doctors for this service. Our doctor locator for all of our contracts has a direct link
to each practice site as they become available. Look for updates on this project
here on our "What's New" page.
Click this button ...
for back ground information on capitation in eye care .
|
|
CONSULTANT’S CORNER
Scott A. Edmonds, O.
D.
I am often asked
to explain the difference between a traditional vision plan and the unique
“Vision Advantage” risk-based plan. I like to make an analogy to the
income you receive from your investments. The difference in the two types
of vision plans can be compared to the difference between investing your
savings in a bank versus investing in a stock mutual fund.
Traditional vision
plans are like investing in a bank. Your income from the bank is low and
steady but there is always business pressure on the bank to lower
your interest rate as much as possible without forcing you to withdraw
your funds. Traditional vision plans are also under continual business
pressure to lower your reimbursement as much as possible without
forcing you to withdraw from their plan.
On the other hand,
stock mutual funds work in a very different way. The managers of these
funds are under business pressure to pick the stocks that will increase
the rate of your return. Likewise, the managers of Vision Advantage
(fellow eye care providers) are also working to increase your
reimbursement. With no “middleman” company, an increase in monthly dollars
paid by patients flow directly to the providers who are delivering the
care.
Like stock mutual
funds, Vision Advantage cannot guarantee the steady day to day
reimbursement of a traditional vision plan. There are no dollars in the
risk pool at the start-up of the first contract. In small contracts, the
patients enter the system gradually, which, in turn, allows several months
of payment to build up in the reserve before most of the patients seek
care.
However, one
problem area in a large contract is often “pent-up-demand”. This means
that the contracted patients have delayed their routine eye care in
anticipation of the start-up of the new benefit. Patients literally pour
into the providers’ offices to use their new eye care benefit on Day One
of the contract. This situation leads to reduced initial reimbursement or
delays in reimbursement to the providers. Once the reimbursement catches
up with utilization however, the program levels off and starts to build
the projected reserves that the network providers need for future
contracts, periodic increases in reimbursement and/or
adjustments in rollover negotiations.
The key issue with
Vision Advantage is control. The providers and members of the Regional
Eyecare Delivery system control all aspects of the vision plan; initial
monthly payment rates for the product, plan design, quality assurance,
cash flow, payment options, renewals and new contracts.
Doctors in control
of Health Care... isn’t that a interesting concept ?!!
Copyright © 1998-2001 THE EDMONDS GROUP All rights
reserved.
Information in this document is subject to change without notice.
Other products and companies referred to herein are trademarks or
registered trademarks of their respective companies or mark
holders.
|
![[Page Banner Image]](images/hnews.gif){kind=small}