An increasing number of eye care practitioners (ECPs) are shuttering their practices temporarily or furloughing staff as the coronavirus continues to spread across the United States, while others are offering emergency appointments only and turning to phone or telemedicine consults to ensure their patients’ healthcare needs are still met, according to the latest survey results from Jobson Optical Research.1
This marks the company’s 4th wave of its ECP Coronavirus Survey, which was conducted from March 28 to 30 and polled the pulse of the profession’s concerns ranging from business decisions to potential financial losses to state and federal resource opportunities.1
Overall, 67.1% of respondents in the 4th Wave Survey closed their practices, a steady uptick from 59.1% of ECPs reporting in the 3rd Wave Survey, conducted March 23 to 24. For practices that had to lay off employees, 42% laid off their entire staff, while 31.1% said they furloughed approximately three-quarters of their employees.1
Despite the pandemic’s impact on practices’ day-to-day operations, responders said they are still reaching out to patients in a variety of ways, mainly by phone (71.6%), followed by social media (56.8%), e-mail (48.3%) and text messages (35.3%).1
The latest survey had the most respondents to date, 1,769, compared with three earlier surveys that were conducted during the first few weeks of March. Of those who responded to the 4th Wave Survey, approximately 63% were optometrists, 31.2% were opticians, 1.9% were technicians, 1% were ophthalmologists and 3% were “other.” The majority, or 65.3%, worked at a single location, and more than half (59.5%) were either the owner or decision-maker in terms of whether to close or stay open.1
SUNY Launches a Telehealth Initiative in NYC
As part of its response to the coronavirus pandemic, SUNY Optometry’s University Eye Center (UEC) recently launched a telehealth platform.1
Patients only need a smartphone, computer or other device with a camera for a virtual visit with a UEC doctor. The telehealth service will allow doctors to safely and easily interact with patients in the community, especially those who are underserved, according to the university.1
This new program will be available for ophthalmic consultations and will phase in various types of services, starting with emergency care needs such as red eye, swollen eyelids and other conditions. Additional services and expanded access will be rolling out soon. The UEC will remain open for patients with urgent care needs who prefer or require being seen in person.1
In the 4th Wave Survey, 94.8% of ECPs said non-essential businesses were closed in their area, which was up from 86.4% in the 3rd Wave Survey. Stay-at home advisories also rose, now up to 88.85% vs. 72.9% from the previous survey conducted just four days earlier.1
A majority of survey responders, 52.3%, said they are rescheduling appointments. Of those who are rescheduling, most replacement appointments are now in May (44.9%), followed by 37% in April and 13.1% in June. A small number of ECPs, just 43, said they are pushing off rescheduling appointments until September or later.1
Regarding hours of operation, most responders said they are considering reducing hours (88.4%). More than half, 51.6%, are thinking about closing temporarily/voluntarily, 50.4% are mulling over whether to open for fewer hours a day and 26.2% are considering opening fewer days per week. Among survey respondents, 17.9% said they would only close if mandated.1
Also of note: 80.2% of ECPs said they would consider seeing emergency cases/by appointment, while 44.2% might close their dispensaries.1
Telehealth options also got a bump in the latest survey, with 19.8% of ECPs reporting they have started to offer this service, compared with just 13.3% in the 3rd Wave Survey. An equal number of respondents in both the current and previous survey (30.5%) are planning to offer telehealth options in the near future.
The financial strain on practices also seemed more dire in the latest survey, with 77% of respondents saying they expected a significant decline in practice revenues, up from 69.5% in the 3rd Wave Survey.1
Looking for some relief, most ECPs in the current survey (56.9%) said knowledge on how to gear up after re-opening would help them the most, followed by understanding unemployment resources (54.9%) and which small business loans are available (54.6%).1
The Profession Mobilizes
To date, the federal government has advised only essential procedures should be performed during the COVID-19 pandemic, and elective procedures, such as cataract surgery, should be postponed. As such, many optometrists have curtailed their practice’s services to emergency patients only, while others have closed until the pandemic is over, or until being told otherwise by the Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS).2
With this in mind, the American Optometric Association (AOA) petitioned the National Association of Vision Care Plans (NAVCP) for practical, temporary relief throughout the pandemic. In a March 23 letter to the NAVCP, the AOA recommended doctors follow the guidance of local, state and federal public health authorities, while asking NAVCP’s member plans to allow additional flexibility for patients and doctors “at this time of need.”2
Closure Trends Two Ways
The Vision Council is conducting a similar weekly survey to track practice effects. Its third iteration, spanning the week of March 23 to 28, found close to 60% of the 386 respondents closed their practice and 72% reduced staff.1
This survey also found closure rates differ by geographical location. The Mid-Atlantic has the highest closure rate of 79%, followed by New England and East South Central at 67% each.1
In the letter, the AOA asked for the following:2
- Extend deadlines for re-credentialing and/or revalidating doctors’ credentials for vision plan networks for three months.
- Refrain from requesting doctors verify their credentials or directory information for three months.
- Provide a dedicated, single toll-free phone number, email address and/or online form for doctors to voluntarily self-report temporary practice updates (such as hours of operation, emergency contact information) that can be added immediately (with the date of the update) to online network provider directories.
Additionally, the AOA asked for temporary revisions in vision plan administration. Due to many office closures, both patients and doctors need some relief from traditional restrictions, the AOA wrote.
Some of these AOA requests include:2
- Expedite new or pending network applications.
- Limit patient cost sharing for out-of-network services at in-network amounts.
- Extend in-network benefits for patients seeing out of network doctors.
- Provide out-of-network doctors easy online access to information about out-of-network benefits.
- Eliminate patient cost sharing for any testing or services related to COVID-19.
The AOA also asked that the NAVCP and its member plans promote and respect the role of doctors of optometry in the COVID-19 crisis, including allowing ODs to order or perform COVID-19 testing, following FDA requirements, provide essential eye health and vision care, including urgent or emergency care, and have the autonomy to follow the advice of local, state and public health authorities and best meet the needs of patients.2
NAVCP shared the letter with each individual plan, and as of April 1, Avesis, EyeMed, EyeQuest, MES Vision, Versant, VSP, United Healthcare Vision and Aetna Vision (in development) have all responded by posting their changes to their plan websites.2
The full letter from the AOA is available here.
1. Closings increase in more parts of U.S., ECPs worry about staff, use of telehealth/mobile communication grows. Vision Monday. www.visionmonday.com/article/closings-increase-in-more-parts-of-us-ecps-worry-about-staff-use-of-telehealth-mobile-communication-grows. March 31, 2020. Accessed April 2, 2020.
2. Updated: AOA petitions NAVCP for temporary relief during COVID-19 emergency, NAVCP responds on behalf of member vision plans. Vision Monday. www.visionmonday.com/latest-news/article/aoa-petitions-navcp-for-temporary-relief-during-covid19-emergency-navcp-responds-on-behalf-of-member-vision-plans. April 1, 2020. Accessed April 2, 2020.