This study was designed to evaluate the impact of introducing a managed vision benefit program on the use and costs of vision services in a managed care setting and also to assess satisfaction with those services after the program was introduced.
Utilization and costs were compared for two groups of patients. The comparison group (n = 36,168) included all patients enrolled for 18 months before implementation of the managed eye-care plan. The study group (n = 23,816) included those enrolled for 18 months following its implementation. Medical claims, survey, and administrative data were used to evaluate study outcomes.
The overall use of vision care was similar before and after the introduction of the managed eye-care programs, with 24% of each group receiving at least one vision service during the 18-month period. Nevertheless, an increase in the use of routine eye-care services and a decrease in medical eye-care services were observed following program implementation. The overall cost of providing eye-care services to patients decreased from $1.86 to $1.36 per member per month after the program started, largely owing to a reduction in spending associated with medical eye-care services. More than 90% of patients surveyed were satisfied with their vision care provided by the program.
Findings suggest that introducing routine and medical managed eye-care programs in a managed care setting allows for a reduction in medical costs while maintaining access to care and patient satisfaction.