Selling Premium Product with Managed Care

2019 • Content, Peer to Peer

I’m Brian Abert, O.D., and I founded Thornton, CO-based Vista Eye Care in 2010. Selling premium product in a managed care environment can be challenging, so let’s start this discussion with a disastrous scenario experienced all too often in eye care.

THE SCENARIO

Mr. Smith presents with a complaint of distance blur through his current spectacle prescription.  Mr. Smith works all day in an office at two computer screens. Over the course of his annual exam, his eye doctor identifies low macular pigment, mild cataracts, and a significant increase in myopia. The doctor hands the patient off to an optician, prescribing Shamir Autograph Intelligence lenses for general wear, Shamir Computer lenses for work use, and polarized sunglasses for outdoor activities and driving. Each pair was also prescribed in Trivex for minimal distortion (the patient has astigmatism), anti-glare coatings (ideal for night driving and working at computers), and Shamir Blue Zero (to minimize macular damage from Blue Light). This array of thoughtfully-prescribed eyewear is custom tailored by Mr. Smith’s doctor to meet his visual needs and to address his health risks.  But after the chart is handed to the optician, the trouble begins:

“Thanks, doc!” the optician cheerfully says as they escort the patient to the practice’s gleaming optical department.  “Mr. Smith, let’s see what your insurance covers!”

THE PROBLEM

Can you see what went wrong above?  Can you appreciate that after nearly an hour of listening, testing, and education, the patient’s visual and health needs were sidelined by assuming that managed care was the patient’s priority.  Maybe because we work with managed care all day, we forget how addressing a patient’s needs should be approached.  Vision plans are a means of payment, and outside of lowering a patient’s cost for materials, there is no need to put an emphasis on them.  Much as you wouldn’t start a sales conversation by discussing the means of payment, we shouldn’t discuss vision plans until after we have presented solutions to the patient’s needs. 

THE SYSTEM

I suggest a simple 3-step system (and you will notice that mentioning of vision plans doesn’t appear until the end):

1. Focus on the patient’s needs. With a good doctor-optician hand-off, the optician should now appreciate what complaints brought the patient in for their eye exam.  The optician should keep in mind the patient’s occupation, hobbies, and eye health needs as discussed at the hand-off.
2. Connect the patient’s complaints with premium eyewear to meet those needs. Those in the eyewear industry know of the recent technological advances in lens material and design.  Patients may not be aware of many eyewear attributes that are common knowledge in our industry, so we must strive to educate patients on what technologies exist to help them.  Without education, patients may assume that glasses purchased from discount sources carry the same benefits as premium eyewear.  In that scenario, the patient’s visual needs are likely not met, and we lose a sale.
3. Utilize vision plans based on the patient’s needs. After the optician establishes what eyewear is needed, the subject of payment can begin.  If managed care necessitates using certain lens materials and designs that wouldn’t allow the patient’s needs to be ideally met, use those vison plan benefits for a pair of glasses that do.  For example, if a vision plan has a mandated ophthalmic lab and a mandated progressive lens design, explain to the patient that their needs would best be met if they used their vision plan benefits on their single-vision sunwear.  This will allow them to purchase their progressive lenses outside of the restrictions of a vision plan and meet their visual needs.

Vision plans may be confusing, though our priority must be to make sure that the patient’s needs are met.  While some patients may have financial limitations that make them want to exclusively utilize plan benefits, many will appreciate that their vision and health needs are best met by using a combination of private pay and managed care materials.

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