COMMENTARY

Understanding What the ACA Means for Ophthalmology

American Academy of Ophthalmology 2013

Roger F. Steinert, MD; Nancey K. McCann; Brock K. Bakewell, MD

Disclosures

November 22, 2013

In This Article

Ophthalmologists, Keep Out!

Ms. McCann: The other point that I would like to make is that ACOs don't necessarily want ophthalmology. When you think about it, many of them are controlled by hospitals, and we are not hospital based. We are outpatient. Our services and our procedures are not the high-dollar ticket items, so I don't think they look at us and see a whole lot of savings. That is another issue depending on where you are. There is not as much interest in involving ophthalmology practices. That is another point that we have made to people on the Hill and in the administration. If you are going to push us into these models, we don't fit in nice and neatly because we are not the high ticket items; we are not hospital based. We are pretty efficient and we have great outcomes. They are focused on more of the chronic diseases, the big-ticket items such as orthopedic surgery, cardiology, and so forth. Again, it depends on where you are in the country. In the Boston area, for example, ACOs seem to have an interest in signing on with some ophthalmic practices, but in other parts of the country, ACOs have not expressed an interest.

Dr. Bakewell: The whole thrust of the ACO is to provide great care to patients who have a lot of chronic diseases to prevent readmission to hospitals. That is what saves them money, and we don't fit into that because we are not doing chronic disease management. We are doing specific procedurally based surgeries that provide great results in a short period of time. We do short bursts of treatment, not chronic disease management, so we don't fit into the ACO model very well.

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