Report predicts $4.6 billion savings with expanded OD scope of practice
ST. LOUIS – The American Optometric Association presented findings of a report that identified $4.6 billion in annual systemwide savings as a result of expanded optometric scope of practice.
The report also concluded that 91% of Americans support laws that allow doctors of optometry to provide the full range of care for which they are trained, according to AOA executive director Jon Hymes here at Optometry’s Meeting.
In addition, the report states that 62% of Americans trust their doctor of optometry to provide their eye health and vision care, Hymes told members of the AOA House of Delegates. Twenty-six percent said they would trust their primary care doctor with their eye health, and 64% would trust an ophthalmologist. Assured access to eye health and vision care is an essential priority for 96% of Americans, second only to overall primary care (97%).
Report author Avalon Health Economics considered increasing demand of medical providers, adequate supply of well-trained optometrists and cost savings afforded by accessibility to optometrists and concluded that full-scope practice by doctors of optometry would result in “$600 million per year in transaction costs savings and another $4 billion per year in savings attributable to access-related improvements in health outcomes.”
The group stated that its research “provides strong support for scope of practice expansion for doctors of optometry in the U.S.”
Sixty-two laws have been enacted in 47 states since 1998 to expand optometric scope of practice, according to the report. Optometric associations nationwide have reduced insurance restrictions and eliminated barriers of access to optometrists with any willing provider laws. In addition, patient safety laws in 23 states protect the public from online vision tests and illegal contact lens sales.
The demand on the U.S. health care system is increasing, and some estimates indicate a shortage of 90,000 physicians. However, there is an adequate supply of doctors of optometry, Avalon stated.
According to an HHS report released in 2018, “states should consider changes to their scope of practice statutes to allow all health care providers to practice to the top of their license, utilizing their full skill set.”
Avalon pointed to the “considerable overlap in the education and medical training for doctors of optometry and ophthalmologists.”
Ophthalmologists may gain general medical knowledge in medical school and learn the specifics of visual systems and eye surgery during their residencies, according to the report. Optometry students concentrate on the eye as well as general medical knowledge and often follow with a residency.
“Consequently, doctors of optometry ... benefit from substantially more applied clinical experience compared to that of a typical medical doctor,” the report said.
Avalon said doctors of optometry reduce the overall transaction costs associated with obtaining eye health services. These costs are calculated using time spent by the patient to obtain care, including travel and waiting time.
The firm also conducted a cost-benefit analysis that considered the health benefits associated with access to care and the transaction cost reductions, which results in the estimated savings of $4.6 billion per year.
Avalon concluded that the U.S. voter support for optometrists to practice at the highest levels of their training and the importance they place on access to such qualified providers “accentuates the disparity between practical application and antiquated opposition to legislative efforts that enhance scope of practice.” This support, in addition to the health care savings estimates, indicate that expanded scope of practice “is necessary to meet the increasing demands on the U.S. health care system.”
“We will be actively spotlighting this report to the public, news media and policymakers,” Hymes said to the delegates. “Review the report and its findings and join the efforts to spread the word and correct the record when it’s needed about optometry’s expanding role in eye and health care.” – by Nancy Hemphill, ELS, FAAO
Disclosure: Hymes is employed by the AOA.