A National Eye Care Communications Project

Why does eye care need a national eye care communications project?            

The changes under way presently in the delivery and reimbursement of health care are occurring outside the normal purview of independent eye care providers. Nevertheless, they will affect the success of your business. The infrastructure of the new system is being formed in every state, in preparation for going national. The National Eye Care Communications Project is a collaborative effort that allows you to work with other eye care providers to understand these changes, and to transform the culture of your businesses, engage effectively in connected care, and build better practices.

What’s driving the change?

CMS is driving a significant transition, one being followed by other payers, away from fee-for-service toward bundled payments. Accountable Care Organizations (ACOs) are now being reimbursed for providing packages of services. In order to retain access to your patients covered under bundled payments, you must gain entry into your local and regional ACOs.

Bundled payment means another subtle transition: away from individual providers to team delivery of care and shared savings. The predominant model is the patient-centered medical home, found within ACOs.  Medical Homes are starting by targeting treatment of chronic conditions such as diabetes and heart disease but are designed to eventually coordinate the care of all chronic conditions.

What does the ACO have to do with the HIE? Why both?

The ACO is a local organization through which team delivery of care and shared savings are offered. Since all chronic care will eventually take place through this group, you will need to be part of it in order to retain access to your patients and grow your business. Part of your eligibility to belong to an ACO is your ability to communicate electronically with other providers. That’s where the HIE comes in. The HIE is the communications network that lets you move protected health information securely from your office to those of other health care providers, whether in your local area or across the country. 

Why should I participate? What does my office have to do?

Ultimately, your success will depend on what you do in your local community. We can expect the process to vary somewhat by state, by ACO and by community. Your participation in the collaborative process of the National Eye Care Communications Project will bring the following benefits, and more:

• you’ll understand the general principles at work as ACOs and HIEs take shape
• you’ll collaborate with other ECPs going through the same process in their communities and see what works and doesn’t work
• you’ll learn how to ensure the local ACO understands what you as an eye care provider bring to the care team, and that it values and encompasses your contributions.

Want to know more about this project? Contact us here.

Alistair Jackson, M.Ed.