By Joe Wende
As EyeMed’s medical director, I enjoy working closely with our clients and the broker community, meeting with them and talking to them about the vision-wellness-disease detection connection.
Obviously, I’m an advocate for vision benefits, but I’m ultimately an advocate for vision care. Vision care is a great contributor for early detection of chronic and costly diseases, making it an important and often overlooked component of wellness and disease management programs.
But before I talk wellness, I know it’s important to acknowledge employers’ healthcare costs and savings concerns, so let’s start there.
Look at the health costs and savings
Vision benefits are relatively inexpensive, with the employer paying a small portion of the cost, or nothing at all. Armed with that important knowledge, you can help your clients focus on the importance of vision benefits to their overall employee health and wellness picture by looking at some bottom-line impacts.
Impact 1: The Centers for Disease Control (CDC) reports that chronic conditions like diabetes and hypertension account for 75% of U.S. healthcare spending – and a large percentage of illness-related absenteeism.
Impact 2: Gallup Analytics showed employers offering vision benefits saved approximately $5.8 billion over four years due to greater productivity, decreased healthcare costs and lower employee turnover.
Regular comprehensive eye exams can identify and allow early intervention for chronic conditions like diabetes, hypertension, heart disease, high cholesterol, glaucoma, cataracts, diabetic retinopathy, and more. Put these together and vision care represents an opportunity to realize significant cost savings through early detection and early intervention.
Because of that, vision benefits that include annual eye exams are one of most important and cost-effective things your clients can do to encourage wellness and drive down healthcare costs.
Here’s a closer look at some of the top chronic conditions I talk about with clients and brokers, their effect on the healthcare economy, and how vision benefits can help.
Costly chronic diseases
In the International Foundation of Vision Benefits Plans’ (IFVBP) “2018 Workplace Wellness Trends Survey,” more than 44% of employers tabbed diabetes as the most significant contributor to health benefits costs.
There’s no question that diabetes has reached near-epidemic status. According to the CDC, 30.3 million Americans have diabetes, resulting in $245 billion in direct costs and lost productivity. Another 84 million have pre-diabetes.
Diabetes is expensive to treat. According to the ADA, diabetics spend about $13,700 per year more on their healthcare than those without diabetes.
But that’s just the start of the ways diabetes affects people’s lives. The American Optometric Association has found that 12,000-24,000 people a year lose their vision because of diabetes complications that often could have been detected early and treated.
Vision care plays an important role by detecting symptoms early and checking on the disease’s progress through regular vision exams.
- High blood pressure
High blood pressure (hypertension) is “the silent disease” that often lacks symptoms – and even though it affects 76.4 million American adults, and is a risk factor for stroke, more than one in five don’t know they have it.
Hypertension was cited for high associated costs by nearly 28% of respondents in the 2018 IFVBP workplace survey – and for good reason: An American Heart Association study found that people with high blood pressure spend nearly $2,000 more per year on healthcare.
Regular eye exams can find changes in the retina’s blood vessels that indicate high blood pressure, and eye doctors can work with primary care doctors to ensure appropriate and timely treatment.
- High cholesterol
According to the American College of Cardiology, high cholesterol affects about a third of U.S. adults, but only a third of that group has their condition controlled.
Untreated high cholesterol increases the risk of heart disease and heart attack, and costs $60,000 for each quality year added to patients’ lives.
Again, regular comprehensive vision exams can detect changes in the eye that are early signs of high cholesterol, making vision benefits a key first line of defense in enabling diagnosis and early management of this expensive condition.
What to look for when evaluating vision benefits
Clearly, vision benefits can be a powerful, painless, relatively inexpensive disease detection and management tool that can help address the health and wellness challenges of your clients and their employees. At EyeMed, we find that more employers are seeing this connection to improving overall health outcomes and savings, and investing in utilization as a result.
So what should you look for when evaluating vision benefits companies – from a member and client standpoint? First and foremost, a lot of support. Vision benefits usually require education and communication for clients and members, so they can understand and value the connection to health, wellness and wallet. And the more they see the connection, the easier it will be for you to sell and implement the benefit.
Also, when evaluating vision benefits, remember to:
- Make sure vision benefits include an annual eye exam. It’s always good to recommend an annual frequency on eye exams because without them 42% of consumers would forgo annual vision appointments and 36% wouldn’t know if they were developing glaucoma or cataracts.
- Look for client integration points. Here I mean things like employee risk assessments, ICD-10 code collection for health plan data integration, and consultations with the vision company’s medical director. EyeMed requires network providers to report on more than 250 ICD-10 codes for eight high-risk conditions, including hypertension and diabetes. This encourages HIPAA-compliant coordination between vision care and medical care and truly helps build the vision-wellness-disease detection connection that makes a difference for employers.
- Look for targeted communications for at-risk members. In addition to assessments and reporting, it’s important that the vision benefits company provide clients the option of sending proactive eye exam reminders to those whose past eye exams indicated a health risk – signs of diabetes, hypertension, or glaucoma, for instance. And for employees who haven’t yet used their annual eye exam benefit, look for a communication program that targets members with eye exam health and wellness messages.
- Make sure members are offered multi-channel communication and education. This starts with enrollment and continues through onboarding and benefit use. A strong program should offer benefit or health fair support through communications and sometimes even onsite representation, new-member welcome kits with member ID cards (even if members don’t need cards, they like having them), vision health e-newsletters and websites, and even member text programs that explain benefits, cover vision care topics and provide opportunity for extra savings perks.
- Ask yourself, “How easy is it to access and use benefit information?” It should be easy for a member to find, understand and use their benefit information. Can the member look up online (or via a mobile app) their current benefit coverage and eligibility, find a network eye doctor nearby or check on the status of their claim?
Next time you talk to your clients about their wellness initiatives and healthcare spending controls, I hope this helps you remember the vision care connection, and helps you help your clients with some of their big challenges.
Joe Wende, O.D., senior medical director for EyeMed, represents the voice of the eyecare professional and offers a unique perspective gained from three decades of wide-ranging experience in vision care, from eye doctor to industry-relations professional. He earned his Doctor of Optometry degree from the State University of New York’s College of Optometry. Visit eyemed.com for more information.