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The NetMinder Blog

Superior Vision and Davis Vision to Merge

Posted by Laura McMullen on Thu, Oct 05, 2017

Centerbridge Partners, Superior Vision’s parent company, and HVHC, a wholly owned subsidiary of Highmark and the parent company of Davis Vision, announced two transactions in August:

  • vision.jpgCenterbridge will purchase Davis Vision, HVHC’s managed vision care subsidiary. Davis Vision will be combined with Centerbridge’s existing managed vision care portfolio company, Superior Vision. Highmark will acquire a minority ownership interest in the combined Davis Vision-Superior Vision company.
  • Centerbridge will acquire a minority equity stake in Visionworks, HVHC’s optical retail subsidiary. Highmark will retain a controlling ownership interest in Visionworks.

In 2013, Superior Vision merged with Block Vision, covering more than 8.5 million members nationwide, with a provider network surpassing 55,000 access points. Vision Monday reports that Superior Vision currently has more than 11 million members. Davis Vision reports more than 22 million members and more than 68,000 points of access including optometrists, ophthalmologists, and retailers in private practice and retail settings. 

With so many mergers taking place in the healthcare industry overall. We decided to also look at the evolution of selling dental and vision insurance as a key part of the total benefits package employers use to attract and retain top talent. Download our whitepaper, Exploring How Dental and Vision Work Together to learn more about the favorable trends as well as the synergies that help the dental and vision insurance markets work together. 

How does this new vision combination change the landscape in your territory?

Tags: Vision, vision networks, Vision insurance, optical retail

The Role of Technology in Expanding Vision Tests

Posted by Laura McMullen on Wed, Aug 10, 2016

This summer, my daughter found out she will need glasses soon, my cousin’s daughter got glasses, and my mom had cataract surgery – I’ve worn glasses since I was a kid so eye exams and buying glasses and contact lenses is always a topic in our house.  

eye_exam.jpgTechnology has made a big impact on vision care. The latest trend is apps to test your vision. When I looked at the iTunes store, I found 10 apps in a search for “eye exam medical” and in Google Play, I found more than 50. They have names like Eye Exam – Eye Test, Eye Test, and Eye Exam. Some of them were created by eye care professionals and others by tech experts. These apps use mobile devices to check for visual acuity, color blindness, astigmatism, and macular degeneration. When you look at the reviews, people rave about the convenience and low price. The results aren’t a prescription that you can use to get eyeglasses or contact lenses. 

Another trend is websites that let you refract your own eyes and send the results to an eye doctor to be certified. Once the results are certified, you can use them to get eyeglasses or contact lenses. Opternative and EyeXam are two of the biggest sites. Opternative markets directly to patients and encourages them to use their prescriptions at any retail location. The results are signed by a board-certified ophthalmologist licensed in the patient’s state. EyeXam markets to eye care providers as a way to attract new patients and to patients as a way to connect with an eye care provider. 

The American Optometric Association is concerned that apps and websites like these are operating without proper medical supervision and recently sent a formal complaint to the FDA. A recent article in Employee Benefit News summarized the AOA’s position: 

  • Self-serve apps and websites can give “inaccurate or misleading information and may miss deeper health issues.” 
  • These apps and websites confuse refraction test and exams. According to healthline.com, a refraction test checks to see that light is bending properly when it passes through the cornea and retina of the eye. The results of this test tell the eye care provider what correction is required to make your vision 20/20. Self-serve apps offer refraction not exams. 
  • More comprehensive adult eye exams should be available to all consumers similar to the pediatric vision benefits required by the Affordable Care Act. 

SHRM estimates that 87% of employers offer vision benefits to their employees and eye exams and refraction tests are the services that people with vision benefits use most frequently. More complicated conditions such as low vision caused by diabetes are usually covered by medical plans.  

More vision tests would seem to mean more people looking for glasses and contact lenses. How do you think these trends will impact your network? 

Tags: Vision, Vision insurance, Affordable Care Act, employee benefits, health insurance

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 insurance, healthcare benefits, Managed Care, employee benefits, vision networks, practicing locations, Vision

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

Are Independent Eye Care Professionals Getting Their Share Of Market Growth?

Posted by Aaron Groffman on Tue, Jun 04, 2013

Vision care products and services sold at U.S. optical retail locations increased 5.8% from $28,624 million in 2011 to $30,287 million in 2012, as estimated by The Vision Council’s VisionWatch report. The nation’s top 50 optical retailers, representing 1 out of 5 retail locations, account for close to 27% of the total vision market, according to Vision Monday’s 2013 Top 50 U.S. Optical Retailers report and ranking.

VisionMonday 20130524Smaller retail chains, defined by VisionWatch as those optical retailers with 4 or more locations, accounted for 29% of the market while representing only 13% of total locations, according to the most recent NetMinder update.  Independent optometrists (eye care professionals, or ECPs, with 1-3 locations) account for 2 of every 3 retail optical outlets and control the largest share of the market.  In spite of their significant presence, ECPs’ market share is only 45%.  Why are ECPs’ revenues per location lagging the chains?  One reason may be that consumers gravitate to ECPs for the smaller, exam portion of the market, while preferring retail chains for the faster growing, more lucrative materials (frames, lenses, and contacts) segment.  

What does this mean for ECPs going forward?  Will they become marginalized by the big chains like so many other industries?  Or will their high-touch approach preserve their market position?

Tags: Vision, consumer choice, Vision insurance, optical retail, sales

How benefits are bought has changed. Have you changed how you’re selling?

Posted by Aaron Groffman on Thu, Sep 20, 2012

Prudential’s Sixth Annual Study of Employee Benefits finds that 40% of plan sponsors say the employee benefits decision-making process has changed in the past five years, with senior management being more involved.  According to John DeLorenzo, SVP or Sales for Prudential Group Insurance, decisions are moving as high as the C-Suite. After interviewing more than 2,000 C-level executives at 500 companies during and before the recent recession, Nic Read, president and CEO of SalesLabs agrees, and thinks it will stay this way for at least four more years.

To land these higher level meetings, Read suggests identifying the gatekeepers to help get you an appointment.  But certainly “cultivate multiple points of entry, and gauge who has “more influence than authority”.  Pursue all options.  Sam Fleet of AmWINS Group Benefits advises his sales staff to “never take a ‘no’ from somebody who can’t give you a ‘yes’”.

Sales representatives need to be more consultative and work with potential clients on a health care strategy:

  • Bring solutions to problems. rather than spreadsheets.
  • Give insights that provoke ideas.
  • Advise
  • Commit the person to something at the end of the meeting that only they can do. Know what that commitment is and propose it before you walk out the door.

It’s clearly more important than ever for the sales consultant to be prepared and armed. We constantly tweak our data to deliver reports that show thought-provoking insights. I’d love to know if you’ve noticed this trend and how you’re responding to it.

Tags: Healthcare, Medical, Vision, dental, employee benefits

Exchanges Mean Insurers Must Market Directly To Consumers To Compete

Posted by Aaron Groffman on Wed, Jul 18, 2012

change3 resized 600 

The recent SCOTUS decision makes it necessary for health insurers to rethink their business models.  This is shaping up to be the most competitive era in healthcare’s history. The ability to recognize and adapt to change is key to survival.  Charles Fine from the Sloane School of Management points out, “thinking cannot be outsourced," and lots of thinking needs to be done right now.

To capitalize on the opportunity presented by ACA, the majority of insurers plan to participate in state health insurance exchanges.  Suddenly, consumers become a crucial vast market which adds a whole new dimension to how insurance companies view their business. PwC estimates health policies sold through exchanges could be worth nearly $60 billion in premium revenue by 2014 and grow to nearly $200 billion by 2019.  Marketing to consumers will change from the current employer-based B2B model to an exchange-based B2C model.

Insurers won’t find much help about how to compete looking within their own industry.  Instead they should be thinking about what companies like Amazon and Zappos and other online retailers did right to get where they are.  They must walk the tightrope between control and speed.  How will insurers reach this crucial market, what will their message strategy be to differentiate themselves from other insurers, and how will they be sure their infrastructure is in place to deliver on marketing promises made?

According to the following article from Employee Benefit Adviser, the insurers surveyed expect it will take approximately 15 months on average to get their businesses ready for exchange certification by the federal government, with 60% expecting it to take 18 months or longer.  How do you think these new challenges will affect insurers?

Providers will need to shift toward consumer-focused model post-reform - Articles - Employee Benefit Adviser.

Tags: Healthcare, Economy, Medical, Vision, dental, Medical, Healthcare

Employers reaching out directly to providers to build networks.

Posted by Aaron Groffman on Thu, Jul 12, 2012

I just read Emily Berry’s recent article in amednews about some employers attempting to manage their own provider networks. Just imagine the redundancies and inefficiencies if all employers decided to contract directly with healthcare providers.  Not to mention the time providers would spend time dealing directly with employers regarding contracts rather than treating patients.

Building and maintaining provider networks is not and will never be a core-competency for employers, and therefore should be delegated to those who do it all the time.  It would be a better use of an employer’s leverage to insist on better contracts and narrow, high-performance networks that the carrier could turn around and market to others, rather than having a “single-use” network built for an individual employer.

There is no official count of how many employers are contracting directly with providers, but industry insiders say there is certainly growing interest.  Am I wrong about this, or does this sound like an idea that may have merit in certain limited situations, but is clearly not scalable?  What are your thoughts?

Tags: Healthcare, Economy, Medical, Vision, dental, Medical, Healthcare

With a few tweaks, ObamaCare might actually work.

Posted by Aaron Groffman on Fri, Jul 06, 2012

While it received most of the attention due to the SCOTUS decision, the individual mandate is not the main problem with ObamaCare.  In fact, from an insurance perspective, having (almost) everyone in the pool is better.  The problem is when you combine the individual mandate with a required minimum benefit that's often too expensive for the new entrants.  The result is too many people opting out and paying the tax, leaving them uncovered for serious illness or injury, and keeping the rest of us on the hook to foot the bill. This clearly defeats the purpose and intention of the mandate.

I agree with Holman Jenkins' assertion in his WSJ piece "ObamaCare—Upheld and Doomed" that a reasonable tweak to make ObamaCare more successful at covering more people without bankrupting the system is to "modify the Affordable Care Act so buying any health policy authorized by the new charter, no matter how minimalist, satisfies the employer and individual mandate." Read the article and let me know if you agree.

Tags: Healthcare, Economy, Medical, Vision, dental, Medical, Healthcare

No end in sight for rising costs.

Posted by NetMinder -Ignition Group on Sat, Jun 30, 2012

 

Georgetown University Center on Education and the Workforce just came out with a comprehensive report on the state of healthcare and its impact on the healthcare workforce by 2020.  Bottom line, in spite of new legislation, there is no end in sight for rising costs. While costs are expected to increase at a slightly slower pace over the next decade, they are still predicted to amount to 20% of GDP by 2020. Because of this rapid growth, the healthcare industry has the p0tential to create 5.6 million jobs between 2010 and 2020.

Our industry clearly has many challenges. They say that every big problem is solved with small steps. Which ones should we be taking to address these predictions of costs that exceed anyplace else in the world?

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Tags: Healthcare, Economy, Medical, Vision, dental, Medical, Healthcare

 

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