Page 19 - 2015 Key Metrics-Assessing ECP Practice Performance

Managed Care

Independent optometric practices receive 52% of revenue payments from health and vision insurance plans, 15% from Medicare and
33% directly from patients. The sources of payments vary widely across practices.

MBA Participant Source of Payments Total OD Source of Revenue: 2011

Other
2%

Medicare
15% Government
(Medicare/
Medicaid) Direct from
Health/Vision 17% patients
Direct from Plans 33%
Patients 52% Private
medical
33% insurance
17%
Vision Insurance
plans
31%

Source: AOA, 2012 Survey of Optometric Practice

Percent of Exams Provided with Managed Care Discount
MBA OD participants reported that a median of 65% of the exams they performed in 2010 had a managed care discount. For 2011,
the AOA reported that, on average, ODs discounted eye exam fees for 61% of patients. In 2001, 47% of OD exams were discounted, as
reported by the AOA.

Percent of Exams Provided with Managed Care Discount

Low Median High

9% 25% 35% 50% 62% 65% 70% 80% 82% 90% 95%

5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th
percentile ranking
AVERAGE=52%

Percent of Gross Revenue from Direct Patient Payments

Low Median High

5% 10% 12% 18% 24% 25% 30% 40% 55% 65% 80%

5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th
percentile ranking
AVERAGE=33%

Key Metrics: Assessing Optometric Practice Performance 2015 17