Thursday, March 8, 2012

Quality Optometry

I just returned from the Presidents Council meeting in New Orleans – minus my luggage. Many subjects were discussed and there was a presentation on EHRs. Oh no – not more on electronic records, health care reform and quality measurements! Well, yes – new information is continually available. There will be presentations on EHR and health care reform at Congress in Bedford Springs in May 2012. Without ruining the surprise elements, I want to share a few aspects with you.

Are you aware that CMS is now sending reports to patients informing them if their physicians are providing quality measures? We all know that reporting these PQRS measures doesn’t make us better optometrists, but it does improve the overall care a patient receives. So why aren’t we all reporting these measures? With or without incentive payments, if you are performing the measures, report them. But in case financial factors are of main concern to you, in 2015 those not reporting these measures will be penalized.

Regardless of how we feel about the health care reform movement, the big factor is the shift from “fee for service” to “payment for performance.” By removing the emphasis from the “procedure” to “patient care,” costs should be decreased while providing better comprehensive care for patients. We all know that optometrists provide quality care for their patients. By reporting the quality measures, we are educating others about that quality care. We will not have to worry about exclusion from health care information exchanges, medical home models or accountable care organizations because others will be aware of the meaningful information we have to contribute as well as the vital role we play in the care of our patients.

This brings me to another important aspect of “quality optometry.” I recently attended a quality management meeting of Blue Cross of Northeastern Pennsylvania. Emphasis was on how this health plan can improve and provide higher standards of care. One of the topics that arose was HEDIS scores for diabetic patients. HEDIS is a tool used by more than 90% of America’s health plans to measure performances on important dimensions of care and service.

Care of diabetic patients includes an annual dilated fundus evaluation. Who is better qualified to perform this service than optometry? And we are performing this service; now we need to report the findings to the PCPs in a timely fashion. These are our mutual patients, so we need to communicate our findings to assist in their total care. On a slightly selfish note, by reporting this information we are reiterating our value in the health care arena. We have proven our worth as primary eye care providers. As they become more aware of the care we are providing, other professionals will recognize the meaningful information we provide in the treatment of the entire person.

In 2009, the POA initiated the Pennsylvania Diabetic Eye Health Alliance (PDEHA) to encourage our members to take that extra step to manage diabetic patients, not simply diabetic eyes; emphasize correspondence with other professionals; and encourage patients to also seek other preventative steps, such as dental and podiatric services. We have many members signed up. The PDEHA section of the POA website includes a primer for care as well as sample letters for communication. If you have not signed up, please do so now by visiting http://www.poaeyes.org/ and clicking on the “More Information for Doctors” link in the PDEHA box on the right side of the page.

Remember to communicate with PCPs. Contact these physicians to confirm their preferred method of communication – fax, e-mail, snail mail etc. Open the doors of communication and demonstrate “quality optometry.” Share what we all know – optometrists are an important component of healthcare. We provide a vital service to our patients. We know it, now others will too.


 
 
 
 
 
 
Donna M. Buraczewski, O.D.
President
Pennsylvania Optometric Association
http://www.poaeyes.org/

Friday, January 20, 2012

2012 POA Board of Trustees and You

Is it just me or did 2011 seem to fly right by? I remember my older relatives and instructors telling me that it only gets faster as you get older. I can’t imagine time going by any faster.

It seems like yesterday that Dr. Daniel Russell was beginning the year 2011 as president of the POA and I was president-elect. Well, we recently held the passing of the gavel and it is now my turn to lead this great organization. I am excited about what the year may bring and what we can accomplish. 2011 was a memorable year in POA’s history – not all necessarily positive. I would like this opportunity to publicly thank Dr. Russell for his unending dedication to the POA and optometry this past year. I look forward to working with him in 2012.

Dr. Greg Caldwell has completed his stint on the POA Board. Fortunately, for the profession, I know it will not be the last we see of him. I know he will be available to assist anyone who may need his help.

The members of the POA are fortunate to have a dynamite Board working on their behalf. We put a lot of time, work and effort into shaping the POA to be a leader in the nation on behalf of optometry. They are passionate for the profession of optometry and are dedicated to the POA.

Dr. Robert Owens of Lancaster is president-elect for 2012. Many of you know Dr. Owens for his years of relentless dedication to the Motorists Vision Committee. I am very excited to have him as my "sidekick" for this year.

Dr. Marianne Boltz has served on the Diabetic Task Force and Pediatric Vision Care Committee. She is also active with the American Academy of Optometry.

Dr. Rich Christoph, Board secretary/treasurer this year, has served on the Corporate Affiliated Task Force and exemplifies the POA’s dedication to all its members in all modes of practice.

Dr. Mark Margolies of Philadelphia is in private practice as is our newest trustee, Dr. Steve Eiss. Both doctors have served numerous roles in their local societies as well as on the state level.

All of these members of the Pennsylvania Optometric Association Board of Directors are available for discussion on any issues or questions you may have. Please get acquainted with all of us and be assured we are working for the betterment of optometry in Pennsylvania.

Now, what can you do for us? Consider serving on committees at your local society level and the state level. Let us know what areas of optometry you are most passionate about and we will get you involved. I know it’s much easier to sit back, let others do the work, and then comment about the way it is done. It is your profession – your career. Optometry is not a career that can be a 9-5 job. It is a dynamic, ever-changing profession that can be altered by outside influences. Do not let others determine our role in vision care or health care.

Be INVOLVED!! Volunteer your time, experience and finances. Attend local society meetings – get involved. If there is a request from Legislative Affairs for you to see your legislator and/or contribute to POPAC – get involved. If the Health Care Reform Committee asks for information regarding third party payers or health information exchanges – get involved. When the POA sponsors educational seminars and meetings – get involved. Do it now, before you know it 2012 will be over. Call us now and let us know how you can help your profession. I know you will not regret it.

I look forward to serving as president for 2012 and being involved with the POA for the rest of my career. I am passionate for optometry.









Donna M. Buraczewski, O.D.
President
Pennsylvania Optometric Association
http://www.poaeyes.org/

Wednesday, December 14, 2011

Winding Down

I will begin by restating what an honor and a pleasure it has been to be elected and serve as your POA president during 2011. I had the good fortune of learning about this association by watching and befriending the very best leaders we have ever had. We have weathered national issues such as health care reform, board certification and Medicaid parity, and many state issues such as changing technology, managed care organizations, and several versions of anti-optometry legislation.

I do need to draw your attention to a bill that is pro-optometry in the Pennsylvania Senate right now. Senators Pippy, Rafferty and Don White introduced this session’s Unfair Insurance Practice Act (SB 939). Other sponsors include Senators Fontana, Ferlo, Brewster and Farnese. This bill, although it has been amended from its original form, is still very positive for optometry and our patients. If passed, it would eliminate a benefit plan mandating the use of a specific lab for ophthalmic products and services. It would stop any assessment of a fee or copayment if a non-required lab is used. It would prevent the creation of preferred classes of providers not held to uniform conditions of participation. Finally, the amended version still contains a prohibition on requiring a provider to participate in a vision benefit plan as a condition of participation in a health care plan. SB 939 passed out of the Senate Banking and Insurance Committee 14-0 and has been referred to the Senate Appropriations Committee. Incidentally, Representative Harry Readshaw introduced the same bill in the House of Representatives, but HB 929 has gotten less attention so far. Please get behind these bills and contact your legislators regarding SB 939 and HB 929. Explain to them how these bills benefit our patients (their constituents) and our profession.

In addition to our legislative issues, we have a lot of other activity at the POA.  Dr. Donna Buraczewski, your POA president for 2012, recently held her planning session for next year. It was very productive and set the stage for the final year of our current three-year Strategic Plan. All uncompleted objectives were given action plans in this final year. I am very excited and looking forward to serving under Dr. Buraczewski and President-elect Dr. Bob Owens.

As I look forward, I also want to take a moment to look back. I want to thank three people directly responsible for my professional success – the two POA presidents before me and our executive director. Dr. Bob Bittel, Dr. Greg Caldwell and Dr. Charlie Stuckey have given me the support and friendship I needed to lead this association this year. We had a bumpy road at times and were dealt some bad hands, but we always acted with the best interest of our membership first in our minds.

I want to thank the unmentioned remainder of the POA Board of Directors: Dr. Marianne Boltz, Dr. Rich Christoph, Dr. Mark Margolies and incoming Board member Dr. Steve Eiss. Remember these names, as they will continue the tradition of great leadership in the years to come. I will join in supporting every one of them. These are all good, smart people and dedicated volunteer leaders! They will all learn how valuable the POA staff can be. I know, but if I mention them each by name they will edit that out before printing this. (Editor’s note: true.) They are great people who work tirelessly to support us and make us look good. To the rest of my colleagues – thank you again for lending me your ear this year with this forum and for all of the support and willingness to help when called upon.

Finally, I want to thank my wife, Danielle, and our three children – Sarah, Jake and Tommy who range in age from twelve to five.  I have either missed (or dragged you along to) many things in the past six years to do this job effectively, and I appreciate that it has been hardest on you!  I love you all!







Daniel F. Russell, O.D.
President
Pennsylvania Optometric Association
http://www.poaeyes.org/

Wednesday, October 19, 2011

Optometry at the Capitol Day a Success

It is amazing what can be accomplished when we all work together. A collaboration of 170 optometrists and students, in addition to several paraoptometrics and POA staff, helped make Optometry at the Capitol Day a big success.

We kicked off the day with a grassroots advocacy program focused on visiting with legislators and raising money for PAC. Presenting were Brian Reuwer (AOA legislative staff, Washington office), Dr. Bobby Jarrell (AOA State Government Relations Committee chair, from New Mexico) and Dr. Bill Reynolds (Legislative Affairs Committee chair, Kentucky Optometric Association). They presented information on the “dos and don’ts” of interacting with legislators. In addition, they provided strategies for getting more comfortable with your legislator and how to grow and maximize that relationship.

I addressed the group with our new Legislative Affairs Committee chair, Dr. Bob Bittel, to provide some history on HB 838 and its predecessors in the Pennsylvania House of Representatives. We were able to introduce the newest members of our lobbying team, the firm of Long, Nyquist & Associates. They have already proven effective in strengthening relationships with Senate leadership.

We also featured a guest speaker – Senator John Gordner, vice chair of the Senate Consumer Protection and Professional Licensure Committee. He has been a supporter of organized optometry and our issues for many years. He shared some personal stories as he looked out into the audience and located his optometrist, Dr. Bob Albertson. Senator Gordner also made some remarks about how we can most effectively support our legislators as we oppose HB 838.

Another focus of the day was expanding our grassroots efforts by strengthening our keyperson system. Definition of ophthalmic surgery legislation has gotten further this session in the legislative process and has begun to awaken the sleeping giant that is our keyperson system. We spent a great deal of time pairing experienced optometrists with both new graduates and PCO students in an effort to develop our keyperson mentorship program. We even saw a number of constituent optometrists step up in the absence of some keypeople and lead these group visits in Senators’ offices. It was great to see some established and newly-developing leaders advocating on behalf of optometry and the citizens of Pennsylvania.

We also had a number of presentations regarding POPAC. We had several new POPAC contributors in addition to having many people increase their level of giving. I would encourage you to review your current level of PAC giving and to increase to the next level as you are able. I would also like to thank our immediate past president, Dr. Greg Caldwell, for leading the POPAC push among the members of the audience. He was able to raise a very significant amount of money in that room in only two hours.

Finally, I would like to thank everyone involved in Optometry at the Capitol Day: the POA Board of Directors, each of whom had a role; the POA staff, who put an enormous amount of effort into coordinating each visit for the optometrists and students; PCO and its administrators, for transporting 85 students to Harrisburg and excusing them from clinic and other educational activities so they could participate in this critically important event; our lobbying team, for everything they are doing on behalf of optometry; and last but not least, all of the optometrists who closed their offices and came to Harrisburg to join together to advocate on our behalf.

Thanks again for the honor of being your POA president and for lending me your ear.







Daniel F. Russell, O.D.
President
Pennsylvania Optometric Association

http://www.poaeyes.org/

Friday, September 2, 2011

What have you been up to?


In addition to constant POA and AOA activity, coaching my kids’ teams and enjoying the play of the Pittsburgh Pirates for the first time in almost twenty years, I have sprinkled in some patient care this summer. I know many of you have been just as busy because I have fielded many questions about the outcome of the POA and AOA Annual Meetings and special sessions from colleagues who were not able to attend. I want to provide a mid-term State of the Association for you and review some of the things you may have missed.

The POA Congress with the Annual House of Delegates in State College in May was a success. We had broad representation of the local societies and a productive House. I would like to thank Dr. John Alexander, chair, and his Resolutions and By-Laws Committee for their work. One duty of this committee is to periodically review old resolutions. From this review, I was directed to set up a committee to review the association’s Code of Ethics. This committee has been chosen, the members are being invited to participate and their report will be presented at the 2012 POA House of Delegates in Bedford Springs.

We also had a great presentation from the Ad-Hoc Committee to study POA Voting at the AOA House of Delegates – thank you to Drs. Tony Diecidue, chair, Bob Bittel, Scott Goldberg and Harvey Hanlen. Their presentation sparked discussion and provided clarity regarding the membership’s representation from the individual through the local society, the POA and on to the AOA. The committee’s PowerPoint presentation is now available on POA’s website in the About the POA section for your review.

Under Open Microphone, Dr. Jim Paulson provided a legislative update and a lengthy discussion ensued – thank you to Jim and his committee. There has been significant activity on HB 838 since Dr. Paulson’s report, and I encourage you to visit POA’s Legislative Priorities page regularly to be kept up-to-date.

In addition, I would like to thank Secretary/Treasurer Dr. Mark Margolies for his work with Joyce from the POA office regarding the 2012 budget. It was presented, discussed and adopted. We also considered the recommendations of the Nominating and Evaluating Committee for the slate of officers for 2012. As a result, elections were held and the Board of Directors is set for next year – thank you Dr. Diecidue and your N&E Committee.

Finally, we had a nice presentation from our AOA Board of Trustees representative. Thank you again to Dr. Sam Pierce for attending and participating in our meeting and for enduring the golf outing with Charlie and me. We had significant rain and that’s what I’m blaming my performance on!

I also had the pleasure of spending five days in Salt Lake City, Utah, for Optometry’s Meeting. It is a very clean city with good public transportation, great hotels and warm June weather with beautiful snow-capped mountains in every direction.

In addition to elite continuing education, a great exhibit hall and top-notch entertainment and friends, we also had a very productive AOA House of Delegates. There were a total of fourteen resolutions submitted for consideration by the Resolutions Committee. Seven of them were withdrawn by their sponsor, including Resolutions B (Optometric Education Curriculum), C (Access to Vision Care for Children), E (NBEO Clinical Skills Exam Testing Site), I (Candidate Status for ABO), J (Affiliate Legal and Defense Fund), K (Evaluate Workforce Statistics) and M (Initial Requirements for ABO). Five Resolutions were passed by vote on the House floor, including Resolutions A (Affiliate Legal and Defense Fund), D (APHA Membership), H (Vision Care for Children), L (Licensure Renewal) and N (Healthy People 2020). Two resolutions were defeated on the House floor including Resolutions F (Feasibility Study of Membership Voting) and G (Support for ABO). Please take the time to review what occurred in greater detail via AOA’s website.

There was also a substantive motion that was made from the House floor regarding accreditation of providers of continuing education instead of individual courses. It was discussed and tabled on Friday and reconsidered on Saturday. It passed as amended and there will be a presentation at the 2012 House in Chicago, Illinois.

Finally, I would like to thank the individual members who actively fought against HB 838 in the House of Representatives. We lost this vote in the House and need your participation to defeat this predatory legislation in the Senate. Please refer to the other articles in this Keystoner regarding HB 838, contact your Senator, give additional money to POPAC and attend Optometry at the Capitol Day. It will require all of our efforts to defeat this bill. Thanks again for the absolute privilege of being your president and for lending me your ear.







Daniel F. Russell, O.D.
President
Pennsylvania Optometric Association

http://www.poaeyes.org/

Friday, July 8, 2011

AOA Congressional Advocacy Conference update

I had the honor and the pleasure of joining Dr. Mamie Chan of New Mexico and Dr. Max Ernst of Kentucky in co-chairing the 2011 AOA Congressional Advocacy Conference in Washington, D.C. You should be proud of the group of volunteer leaders that made up the Pennsylvania delegation as well as the outstanding group of students representing our Commonwealth. We had eight optometrists and thirteen students in our group and were able to effectively advocate on optometry’s behalf.

With the mid-term election shift that occurred in both the House of Representatives and Senate, there are many new relationships to be built and opportunities to be seized in Washington. When I visited Senator Pat Toomey’s office, for example, he was located in the basement between two Senate buildings as he hadn’t been assigned an office yet. It was a pleasant visit and because we didn’t have a specific “ask” or any legislation in the Senate right now, it was the perfect time to start a relationship with Senator Toomey. With this shift in power from one side of the aisle to the other comes great uncertainty with regards to health care reform. The message we received was consistent and clear – when all the discussion is over and the dust clears, there will be at least some aspects of health care reform that remain. Regardless of your political views, we have to ensure that optometry is properly positioned for inclusion in the new health care model.

This brings me to the first piece of bi-partisan legislation that we support. HR 1219 is the Hall-Schakowsky Optometric Equity in Medicaid Act. As you may know, Doctors of Optometry have been formally recognized as physicians in Medicare since 1986. Unfortunately, Medicaid fails to fully recognize optometrists as the primary eye health and vision care providers that we are. This presents a major access problem as we know that the bulk of the newly-covered citizens under the state Insurance Exchanges will come in through the Medicaid program. In addition, studies show that there are 3,500 communities across this country where optometrists are the only eye doctors.

The second piece of bi-partisan legislation we support is HR 1195, the National Health Service Corps (NHSC) Improvement Act. Optometry is currently excluded from participating in some federal health programs like the NHSC. Approximately 11% of NHSC community health center facilities have eye care in the impoverished or underserved areas in which they are located. Again, this is another problem with access to care. The program through the NHSC allows health care providers to work in an underserved area in exchange for debt relief dollars but optometrists were not included in the 2002 restructuring of this program. This change would not require any new federal spending, it would simply allow our debt-ridden graduates to compete for debt-relief dollars that already fund that program and put primary eye care in additional NHSC facilities.

So check out the link below to see some of the highlights of the AOA Congressional Advocacy Conference and know that the present and future volunteer leaders in Pennsylvania are advocating on your behalf. Thanks.

www.youtube.com/watch?v=AUxtFabucM0&feature=youtube_gdata_player







Daniel F. Russell, O.D.
President
Pennsylvania Optometric Association

http://www.poaeyes.org/

Friday, April 1, 2011

After 13 years, small dues increase necessary to balance POA’s budget


We spend either a great deal of time or a great deal of money keeping our books or having someone keep them for us. We have office managers, accountants or tax advisors at a minimum. That is unless we take on the impossible task of paying bills, paying staff and monitoring things like fixed costs and cost of goods between patients and in our "free" time.

I want you to know, or remind you, that we have the very best people in place at the POA office to "keep" our professional association’s books for us as well. The staff and volunteer leaders we have in place to budget our money and manage our programming are second to none. They were tasked with designing a budget for the 2012 calendar year very early in 2011. While obviously difficult, they have historically done a great job at projecting income and expenses, sometimes eighteen to twenty months in advance. The reality of it is that we have ended some fiscal years in the black and some in the red. This has enabled us to propose twelve straight dues-neutral budgets to the POA House of Delegates.

Despite priding ourselves in being fiscally responsible, we have ended the past two years with meaningful deficits. This has been due to a combination of an increase in costs, a decrease in dues income and a decrease in non-dues income as well. We have all felt the increase in operating costs over the past twelve years – there is no mystery there. Our dues income has been falling despite our membership numbers holding steady. How can that be? We have seen an increase in the number of "Life" members as the AOA (2007), and subsequently the POA (2008), made changes in by-laws lowering the age requirement for Life membership by 10 years, which increases our number of non-dues paying members. We have also seen a shift in membership to "Partial Practice" and other less-than-full dues categories. All of these changes have resulted in a decrease in the amount of our dues income.

Surprisingly, our budget is only about 55% dues revenue with the balance coming from our non-dues income. We have also seen a decrease, or at least a lack of growth, in non-dues income. We have fewer people participating in POA programming and revenue-generating activities.

The results: a proposed 2012 budget at the 2011 House of Delegates in State College that has a small dues increase. We have concentrated in the past on controlling programming expenses and keeping dues rates flat but this has not allowed us to cover increases in operating expenses. The hope is that this small increase will also allow for development and expansion of some POA programming that had been impossible in the past. Our goal is ultimately to serve you, our membership, and to provide you with the highest level of programming and advocacy. So review the proposed budget for 2012 on page 4 of the April Keystoner and attend our May 2011 POA House of Delegates in State College. See you there and, again, thanks for your ear.






Daniel F. Russell, O.D.
President
Pennsylvania Optometric Association