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The NetMinder Blog

Focusing on vision networks

Posted by Laura McMullen on Tue, Jul 07, 2015

A few years ago, we published a whitepaper called Clearing Up the Vision Market. Since then, the demand for vision networks has increased significantly with the number of people who take a vision plan when it’s offered growing from 78% in 2012 to 83% in 2013 in a 2014 SHRM study on vision care, so we decided to take another look.

As of March 2015, there are 48,000 optical locations in the top 10 national vision networks. They fall into two categories: independent eye care professionals (ECPs) and retail chains.

  • ECPs are defined by VisionWatch as having three or fewer locations with an ophthalmologist, optometrist, an optician, or an optical retailer on site. Nearly all ECPs are small businesses.  According to a whitepaper sponsored by Vision Source, ECPs are typically single location operations with less than $1.5 million in annual revenue and 12 or fewer employees. They have been in practice on average for 20 years.
  • Retail chains have 4 or more locations and may or may not have an ophthalmologist or an optometrist on site. The best-known brands in this category are widely available, such as LensCrafters, Pearle Vision, Walmart, and Costco.

ECPs make up two-thirds of locations and 45% of market share while retail chains are the rest. A recent Bain and Company study shows the second most influential factor (after cost) in selecting a managed vision care plan is the retail network the plan provides. This helps explain why retail chains account for 55% of vision sales, with only one-third of the locations.

A Consolidating Market

In a recent Wall Street Journal blog post, Optometrists Catch FFL’s Eye, Thomas Puckett of merger and acquisition advisory firm HPC Puckett & Co., said “There aren’t many operators with over 100 locations, but there are quite a few independents with under 50 locations. It is logical for businesses to consolidate in a geographic area.”

Private equity firms are projecting that the number of retail outlets will drop by half over the next five years through consolidation. Investors are most interested in firms valued at $10 to $50 million and the expected growth from the Affordable Care Act and the aging US population makes the industry even more attractive.

Other Vision Network Trends

A recent review of the top 10 national vision networks in NetMinder found some interesting trends:

top_10_vision
  • Vision networks are growing. The number of unique providers in these networks grew about 8% annually from 2011 to 2015. Unique locations grew more slowly (3% annually) and access points grew more quickly (11% annually). This is most likely because retail chains, such as Pearl Vision or Lenscrafters, generate more revenue with fewer locations.
  • Some ECPs practice at many locations. On average, ECPs are listed in provider directories at 2.4 locations with a range of 1.6 to 3.2 locations. This could be the beginning of a trend toward overstated access in vision networks. We see about 25% access point inflation in dental PPO networks and have put a validation process in place using claim data to adjust counts. We are watching vision networks closely to see if a similar filter is needed. 
  • vision_networksECPs are joining more networks. In March 2011, the average ECP participated in 2.5 networks. By March 2015, that count was up to 3.7 networks. This shift is quite dramatic: five years ago 75% of eye care providers in these networks were in 1-3 networks and now only 53% are while 15% are in 7-10 networks.


Are you seeing these trends play out in your network? Are vision benefits in demand among your customers and their employees?

Tags: network providers, Affordable Care Act, optical retail, Vision, Vision insurance, healthcare benefits, Managed Care, employee benefits, vision networks, practicing locations

How Will ACA Affect Managed Vision Care Network Models?

Posted by Aaron Groffman on Tue, Aug 13, 2013

As healthcare reform continues to take shape and the market becomes even more consumer-centric, insurance companies need to make sure their networks are in line with what customers want. The Patient Protection and Affordable Care Act (ACA) will create new market opportunities  both inside and outside of exchanges  for vision providers and insurers.

For example, the public exchanges will require all medical plans to include pediatric vision coverage, potentially increasing the number of people who will get regular vision exams. On the other hand, ACA could mean that standalone vision plans will appear more often outside of the exchanges because public exchanges might exclude ancillary plans. Voluntary vision coverage tends to be a popular benefit with employees, however, so it’s unlikely that these plans will be going away anytime soon.

What types of plans do consumers prefer? Our research shows that managed vision care plans have to include a mix of independent eye care professionals (ECPs) and retail chains in order to win over consumers. So the next questions are: how are they currently achieving this balance and what are the most common network models?

The three primary types of network models in managed vision care are:

  • Flat organizations contract primarily with ECPs and a limited number of the smaller chains;
  • Vertically integrated organizations, whose networks include their own retail stores as well as ECPs and other retail chains;
  • Hybrid networks have more of an even distribution between ECPs and retail chains

To determine which approach makes the most sense for each managed vision care network, the planning process needs to account for the ACA’s impact (which seems to favor ECPs) and the growing corrective materials market (which seems to favor retail chains).

To learn more about managed vision network models, watch our free webinar: Clearing Up the Vision Market.

Tags: Affordable Care Act, vision market, Vision, Vision insurance, healthcare reform, Managed Care

Join Me at World Congress!

Posted by Aaron Groffman on Wed, Feb 20, 2013

World Congress logoHealth plans, insurance carriers and brokers will convene March 13-15, 2013, to learn how to leverage ancillary and voluntary products to increase their competitive edge and meet the needs of a consumer-driven market.

The World Congress 3rd Annual Leadership Summit on Ancillary Products and Voluntary Benefits will take place in Orlando and feature industry-leading speakers from CIGNA, United Healthcare, VSP Visioncare, Integrated Benefits Institute, Prudential, Blue Cross and Blue Shield, Health Plan Week and more. Session topics include meeting consumer needs, health reform, member acquisition, public and private healthcare exchanges, business innovations and other issues affecting the healthcare industry.

Join me on March 14th as I present “Using BIG Data to Get BIG Results in Ancillary Benefits.” We will explore the following ideas:

  • What’s big data? Does it apply to healthcare?
  • Learn how other carriers are using their big data to create competitive advantages.
  • Teach your sales and network teams to leverage big data to get big results.

If you'd like to attend the World Congress, be sure to register with promo code TAU676 and save $400 off of your attendance fee! (Discount is not valid toward government rates.)

I would love to see you in Orlando. Will you be attending the summit? 

Tags: dental insurance, Ancillary benefits, Vision insurance, Managed Care, Specialty Benefits, Ancillary Products, Voluntary Benefits, Benefit Design, Benefits Consultants, Insurance Brokers, Health plan, World Congress

 

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