How EyeCare for You went out-of-network
Dr. Kara Ramsey is helping eye care providers drop managed care. And to understand why, you have to hear her own direct care story and how her practice achieved 20% annual growth out-of-network.
As part of a webinar partnership with Marketing4ECPs, she spoke with Anagram's Jenna Slater about how her North Carolina practice, EyeCare for You, broke from managed care. The discussion touched on topics such as:
- How her practice dropped off vision plan panels.
- Explaining direct care to patients.
- Patient flow amid the coronavirus pandemic.
Something didn't seem right
These days Dr. Ramsey is helping optometrists discover direct care. However, that wasn't always the case. She opened EyeCare for You in 2015 after working as an associate at another practice. She wanted to run her own business and put her ideas to work. However, it wasn't long after opening EyeCare for You that she began to recognize something wasn't right.
She was spending too much time chasing payments and rushing to the next appointment. That didn't leave enough time for patients. And she felt dropping direct care would help her solve the problem. After all, how can you consider your time valuable if you're receiving $3 reimbursements for contact lenses? Or feel like your business is yours if you're forced into hiring a new employee just to keep up with in-network billing requirements?
Dropping managed care at EyeCare for You
Dr. Ramsey decided to drop managed care and turn EyeCare for You into a direct care practice. At first, becoming an out-of-network provider seemed intimidating. How do you tell your patients? How do you sell the value an out-of-network practice offers them? What's new about the billing process and is their software that can make it easier?
Ultimately, it paid off for the practice. But first, let's take a look at how they dropped managed care.
How EyeCare for You dropped managed care
When it comes to dropping managed care there are two schools of thought: All at once or piecemeal. Each has benefits and disadvantages. It's up to you which makes sense for your practice. Dr. Ramsey decided to drop all plans at once.
"We were thinking about dipping our toes in the water one at a time," Dr. Ramsey explained, "But we decided to make it more about a movement ... Let's change the healthcare system. Let's do our part in making healthcare better by laying out our prices across the board; we'll file for you still for reimbursement ... It's really about helping to change the healthcare system."
She explained to all of her patients that the change would improve the quality of care EyeCare for You could provide. After notifying her patients, Dr. Ramsey and her team transitioned to direct care.
Direct care offered more value for practice and patient alike
What happened after Dr. Ramsey and her team put her plan to work? The patients who were looking to squeeze their plans for benefits at minimum cost left. But the majority stuck around and some who left eventually returned.
It paid off for the patients and practice alike in how things improved. For example, it became easier for EyeCare for You to include testing in appointments or squeeze in a visit from a patient with an unexpected need for a prescription change. Why? Because these interactions didn't require Dr. Ramsey and her team to start the administrative process all over again.
Instead, they had more control over patient flow and more time to spend with each individual during appointments. And when it came to verifying benefits or filing claims, they just used Anagram instead of dealing with the hassle of calling vision plan providers to verify plans or asking patients to submit.
Dr. Ramsey also had more certainty about her rates. That allowed her to be transparent about pricing across the board and include rates on her practice website.
How direct care led to 20% annual growth
The changes Dr. Ramsey and her team made produced 20% annual growth for the practice. While some patients did leave, many of them came back after realizing the quality of care they left behind. Over time, EyeCare for You's increased revenue per patient as a direct care practice more than made up for those who didn't come back.
With the transparency and better quality of care Dr. Ramsey and her team were able to offer, it wasn't hard for EyeCare for You to keep most of its patients. And the growth been so substantial, Dr. Ramsey is sharing her journey with other ECPs interested in direct care.
Learn more about Dr. Ramsey's story:
