Independent Eye Care

Earn a few dollars more: What is independent eye care?

The obvious answer? Independent eye care is any practice that is owned locally and isn’t subject to corporate rules or limitations. But we think it's more than that.
Published 9.21.2021

The forces of corporate consolidation are sweeping through the eye care industry like bandits through the Wild West, snatching up labs, practices, materials and brands—all in the name of profit.

Now, that’s not to say making an extra buck is a bad thing. Just look at the title of this blog; we think you should embrace growing your business. However, profit at the expense of patients is something we can’t get behind.

Whether it’s private equity consolidation or vertically integrated brands in the eye care industry, their purpose is usually the same: Redirect profit toward the top. This profit-at-all-costs attitude remains the same regardless of how it impacts practices and patients. But we’re seeing a response to these unfortunate trends.

Independent eye care providers are looking for and finding ways to reclaim control over their practices.

What is independent eye care?

Independent eye care providers set their own standards of care for all patients, decide which products they carry, choose which labs they work with and determine prices for the eyewear they’re dispensing.

In that sense, independent eye care is more than practices that are owned locally and aren't subject to corporate rules or limitations. It speaks to the quality of care you’re able to provide because of the flexibility you have to guide patient care. And, whether it’s eye care or anything else, people recognize that.

In fact, 91% of people prefer to support small businesses over large corporations when they can, according to Zendesk research. Furthermore, 77% don’t mind paying more if they get great customer service. What guarantees your ability to provide great service to your patients? Reclaiming control over your practice.

Most ECPs have an entrepreneurial mindset. When you own your own business, you want to run your own business. Independent eye care scratches that itch by allowing you to run your business without constraints from outside entities. And, these days, there sure are a lot of outside entities doing a whole lot of constraining.

Vision plans started out to help small providers, but are now squeezing them out of business in favor of their own franchises.
Vision plans started out to help small providers, but are now squeezing them out of business in favor of their own franchises.

Third-parties and vertically-aligned corporations squeeze providers

Initially, vision plans set out to do something good in the marketplace: Level the playing field between independent eye care professionals and big box retailers who owned labs, lens companies, frame companies, a gigantic marketing apparatus, and various other tools at their disposal.

These days, vision plans are among the biggest culprits of putting more constraints on eye care providers. It is nearly impossible to operate with complete independence if you’re contracted with a vision plan. Larger plans that vertically integrate with other entities in the industry only make it harder.

If a vision plan has its own labs, its own lenses, its own frame lines; then which labs will you work with or which eyewear will you sell? Chances are it won’t be up to you. The vision plan is providing you with patients, so the vision plan will heavily influence or outright choose what you end up selling and who you work with. It will even set your prices and sometimes determine the level of care patients receive.

At that point, how independent are you really? Are you running your own practice or taking care of a vision plan’s patients for them? Think about how a vision plan might answer those questions.

Vision plans are one of many competitors and constraints

But it’s not just vision plans chipping away at eye care independence in today’s vision care industry. Everywhere you look vendors and partners are offering compelling deals with equally disappointing fine print.

You can open an account with a popular frame line, but only if you make a bulk purchase that may not make sense for your optical. You can get cash back on your wholesale purchases, but only if you buy in bulk and dispense more eyewear than your patients can even keep up with. And, don't forget, you'll need time to track your sales to make sure you’ve qualified for your rebate.

That’s to say nothing of the equally disappointing rebates contact lens vendors offer your patients as long as they’re willing to jump through a bunch of archaic hoops to redeem the reward.

How does that experience offered by a third-party vendor reflect on your practice? Remember, your patients see everything they experience at your practice as a function of your practice.

Or maybe you get an offer from a lens manufacturer to fund a remodel for your showroom—as long as you sign a contract to sell only their lenses for the next few years. Even buying groups and alliances that negotiate lower wholesale price lists and better vendor terms on your behalf have their motives. Look at everything you have to do to hold up your side of the agreement!

Private equity and vertically integrated corporations insert themselves into the patient-provider relationship to extract profits.
Private equity and vertically integrated corporations insert themselves into the patient-provider relationship to extract profits.

Vision care corporations are willing to offer you plenty of deals that ultimately end up pretty one-sided in the way they funnel profit away from practices. Nevermind how all these requirements affect the patients!

Eye care independence means being able to manage your own inventory and make your own purchasing decisions. Or having the freedom to set your own prices. You should be able to choose what’s best for your patients; not required to go with what’s best for your so-called corporate partners.

To be clear, there are plenty of excellent frame companies, lens companies, buying groups and alliances for you and your practice to work with in the space. It is tremendously important that you put in the time up front to understand who you’re going to be working with and to hitch your wagon to the right horses.

Why is independent eye care better for providers?

Given everything above, the answer to this question may seem obvious already. But before we go any further, let’s take a look at exactly how independent eye care providers and their patients benefit from removing third-party constraints.

Profit without profiting at all costs

Profit may not be why you got in the business, but it helps keep you in it. Like any business you need to make money. The goal is to enjoy a profit while providing the best eye care available.

The problem with the competition and corporations chipping away at independent eye care is that they’re focused on profiting at all costs. For that reason, they compel ECPs to sign agreements that aren’t always in the providers’ or their patients’ best interests.

These one-sided deals lock ECPs into contracts that give them something they need in exchange for profit the third-party “partners” crave.

Dispense the eyewear that your patients want

Join a vision plan network and next thing you know your optical inventory is composed entirely of brands of their choosing. Why? Because they own those brands as well.

As the industry consolidates, agreements to sell specific eyewear brands are commonplace because vertically-integrated corporations are looking for more ways to squeeze profit from your partnership. Is the frame line what your patients want? Are these lenses the best available? The answer isn’t important if you're in an agreement with their parent company.

But vision plans aren’t alone in constraining the brands ECPs can sell. For example, if you open an account with a new vendor or agree to a new price list, they may require you to sell certain products. In order to meet minimum requirements, you may have to set aside the best eyewear for your patients in favor of the brands listed in your agreements.

Is it your business if you can’t choose the eyewear on your frame boards?

Work with your preferred partners and vendors

What happens when lens companies own labs? You have to work with those labs if you have an account with those lens companies. You may have a lab in your area that completes jobs twice as fast, but patient experience isn’t the priority.

It’s the same when vision plans own EHRs, lens brands or labs. Industry consolidation narrows your menu of vendors and partners down to just a few choices at best.

Guide patient care without outside interference 

You got into this to improve your patients’ eye health and provide the services and materials they need to stay healthy. But too often it’s third-parties making the decisions about patient care.

In-network eye exams don’t usually include retinal photos, OCTs or visual field exams. Vision plans think all your patients will need are a refraction, a dilated fundus exam and a few entry-level optometry tests once per year. Plus, their quantity over quality model means you have to fill your book with appointments instead of spending more time with your patients.

When vendors ask you to work with their lab partners or sell their subsidiaries’ materials, they’re not doing so with the patient in mind. That’s not what you got into eye care for, is it?

Eye care independence gives you the freedom to make the best care decisions for your patients.
Eye care independence gives you the freedom to make the best care decisions for your patients.

Why is independent eye care better for patients?

Vision plans, big box retailers, massive vertically integrated organizations are not in the business of providing patient care; they’re in this for profitability.

Sure, some elements of these organizations are technically not for profit, but rest assured that overall they’re aiming for profitability over patient care. Like gym memberships, vision plans rely on their user base paying their monthly dues without taking advantage of the benefits they’re entitled to; when that happens, vision plans make out like bandits.

How should the quality of patient care be defined? By the patient and their doctor working together to create the best possible outcome for the patient, or by vision plans seeking to be profitable?

How to reclaim your independence

There’s a lot to look out for if you intend to be an independent eye care provider. Vendor agreements, pricing deals, funding offers, new patients and more all come with a catch: Your practice independence. They all require you to work for someone else.

So how do you avoid that and remain independent? Well, we’ll be honest. Sometimes you can’t. Sometimes you need a frame line in your inventory and you’re just going to have to make an agreement with the vendor. However, planning for the requirements ahead of time and managing your inventory around this agreement will help you maintain control over your business.

Partners that put you in control of your practice

But, outside of those occasions, eye care independence really is in your hands. It comes down to relationships. Being independent doesn’t mean you have to go it alone. It just means your partners understand you know what is best for your business and your patients; and they respect that.

Which frame lines do you feature? With lenses are you selling now and which would you prefer to sell? What are the requirements to open accounts and start working with these brands? If they’re overburdensome, you should ask whether those conditions are really worth it. Especially when there are pricing agreements that can secure you better wholesale rates and terms for the same products.

But, be careful about price lists as well. They can also come with demanding provisions that shift control over your inventory to third parties and their preferred partners. Look for agreements that offer transparent, standard pricing and terms across the board for providers of all shapes and sizes. Price lists that don’t burden members with extensive conditions leave ECPs with more room to operate.

The most important consideration, though, is the patient. You’re looking to provide your patients with the best care available. Your partners should understand that and leave patient care decisions to you. You're the best judge of which services and materials your patients need.

We like to call it like we see it. And the way we see it, private equity, vertically integrated corporations, vision plans and the like are all in it for profit, not the patient.

Where are the vendors and partners who are ready to put the patient-provider relationship back at the center of eye care? Join Anagram as we build a new way forward for independent eye care and the patients who want to give you their business.

Connor McGann
Connor McGann, Content Marketing Manager
Connor McGann is Anagram's content marketing manager. He joined Anagram in February 2020. Previously he was a finance writer and animation project manager at a marketing agency, and managed content for a live chat provider that serviced various industries including health care and plastic surgery.

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