Independent Eye Care

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The optical industry has undergone significant changes in recent years in general and more specifically in the MD/OD space.
Published 6.30.2023

Those challenges have been further exacerbated by the rise of Private Equity and the increasingly prominent role those groups play in shaping the present and future landscape.

Whether your business is owned by Optician, OD, MD, or Private Equity, it is essential to run it with intention, to keep your finger on the pulse of practice culture, to understand vision plan reimbursements and complexities, to stay up to date on industry trends and technology, as well as finding ways to understand your data to be sure you are doing all you can to maximize your revenue and continue on a path of growth and success.

That’s a lot to keep in mind in addition to patient care and everything that entails, but nobody said owning an eye care practice in 2023 would be easy.

Private Equity’s entry into the eyecare space provided both opportunities and challenges for optical businesses. As part of a larger entity, leaders could go to market and negotiate favorable contracts with frame, ophthalmic lens and contact lens vendors which would reduce their costs significantly. However, they also faced challenges.

Vision plan profitability and complexities

With multiple different businesses merging, the consolidation of vision plans each individual business was credentialled with, came added complexities. ODs, MDs, opticians, and billers alike found themselves not with a streamlined process because of their larger organization’s buying power, but on the business end of a much more complex billing, reimbursement, and write-off process than they expected.

In these scenarios, tracking data to verify the employee’s understanding of what to offer patients and when, and why, is difficult. In a highly organized system, however, a practice leader can and should go through each plan methodically to understand how the practice needs to address each in order to be profitable. Assess the profitability of each individual vision plan using your own historical data, and determine which plans in their present state are worth retaining and which are not.

It is important to consider the capacity of your employees to fully understand how each plan works in terms of delivering quality work for your patients and keeping your practice’s financial success in mind. In my experience, being in-network with more than 3 plans creates confusion among team members; this can lead to mistakes being made not only in the money collected for overages, but in selecting the right brand of lenses as dictated by the insurance plan’s reimbursement schedules. This result can be disastrous for the business and can be readily seen in the dwindling profit margins and worsening execution in the optical.

For plans that are not profitable, the business entity can become an out of network provider, clearly marketing their “why” among the plan members along with providing an attractive package for their eye care and eyewear so that they continue receiving care at your office. It is essential in these scenarios to make it as easy as possible for patients to do business with you, which may include using a tool like Anagram to pull their out of network benefits and submit their OON claim on their behalf. This approach can also be an effective way to see other vision insurance patients that you already know are not profitable for you on an in-network basis.

Patient Experience and Tech

Delivering exceptional patient experiences is vital for attracting and retaining patients regardless of whether you are a private MD or OD practice, or PE owned. I have witnessed difficulty in this area in the PE space, especially during the transition and into the first year after acquisition. The acquired individual businesses can become confused about the new mission and values of the PE and how they align with their previous practice. Oftentimes, turnover is higher at the outset and having a strong optical director and people operations to focus on employee retention, listening to concerns and allowing feedback that is directed appropriately to business leaders is essential.


Diversifying service offerings can help capture additional revenue streams. ODs and MDs can consider expanding their scope of practice by providing specialized services such as dry eye management, sports vision training, or myopia control. Collaborating with opticians to offer this comprehensive range of services is beneficial.


Investing in a solid optical EMR system can significantly enhance the efficiency and profitability of an optical department in the MD space and goes along with promoting a good work environment for opticians. A seamless integration between the clinical EMR, the practice management system and the optical EMR solutions can streamline processes, improve patient care, and increase revenue. In addition, the system should be capable of interfacing with third party systems such as the lab software system and contact lens distribution software reducing the amount of double order entry and in turn the opportunity for user error when processing orders.


To thrive in today’s hypercompetitive marketplace it is essential in the OD/MD space as indeed it is across the industry to have your own ecommerce platform. Your patients want convenience and access on demand, and the only way to provide that is to be online when they’re looking for you. You’ll want an e-commerce solution that sends reminders to patients when they are coming close to being out of contact lenses, as well as virtual try on capabilities.

Prior to the patients’ exam, an automated text message can direct them to your virtual online store where they can browse your frame selections and put a few frames that appeal to them on hold. After the exam, the optician will review their selections with them providing counsel on best fit and features and of course present them with other styles as appropriate.

Wrapping Up

Maximizing revenue in the OD/MD space requires a multifaceted approach that balances quality patient care with sound business strategies. Embracing technology, enhancing the patient experience, expanding services, and implementing effective marketing techniques can all contribute to financial success. Think about what not doing those things will mean for the long term success of your practice.

While private equity firms can bring financial resources and expertise to the table, healthcare professionals must carefully consider the implications and potential trade-offs associated with private equity involvement. By navigating these dynamics thoughtfully, ODs and MDs can position themselves for long-term profitability while maintaining a focus on delivering exceptional care to their patients.

Barbra Dey
Barbra Dey, Optometrist/Founder Dey Ophthalmic Consulting
Dr. Dey began her eyecare career with a degree in optometry from Technological University Dublin. After practicing in Ireland, England and Australia, she moved to the United States and passed her Optometry boards (NBEO). Since the end of 2021, she has been working with eyecare practices across the US helping them streamline and simplify their optical operations focusing on leadership and employee engagement, career pathing and coaching, enhancing utilization of optical software systems to promote efficiencies across the business, implementing optimal purchasing and pricing strategies, and vetting in-network vision plans.

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