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How Pairing Employee Vision Coverage With Medical Insurance Equals Better Health, Less Hassle and More Savings

Good eyesight is key to doing most jobs and eye health is an indicator of overall wellness. That’s why vision coverage is so important.

In fact, a visit to the ophthalmologist or optometrist can uncover more than just eye problems. An eye exam can reveal chronic conditions such as diabetes, hypertension and multiple sclerosis (MS). Further, an eye doctor may be able to detect some cancers, including melanoma, before a patient notices anything is wrong, as well as assess the spread of someone’s cancer. Lung cancer, for instance, can spread to the eye, and an eye doctor may be the first to notice that.

The Cleveland Clinic even reports connections between inflammation in the eyes and certain inflammatory diseases, including Crohn’s disease, ulcerative colitis and lupus.

Why Sharing Vital Health Data Matters

When your insurance carrier pairs vision coverage with medical coverage, it has access to data that supports a whole-person approach to employees’ health. What an eye doctor finds, they can share with an employee’s primary care physician or the appropriate specialist — and vice versa. This collaboration covers:

  • Medications and vision
    Many common medications have vision-related side effects, including some chemotherapy agents, oral diuretics and drugs for erectile dysfunction, according to the Review of Ophthalmology. Often, these side effects go undiagnosed. If an ophthalmologist knows which medications your employee is taking, they can watch out for specific side effects.
  • MS identification
    Eye care experts can identify unusual changes during an exam that could be the first sign of MS. For roughly 20% of individuals with MS, optic neuritis — an inflammatory injury of the optic nerve — is the first clinical sign of the disease.
  • Lupus identification
    Changes in the eyes could also signal lupus. The symptoms of lupus include inflammation of the white outer layer of the eyeball, retinal blood vessel changes and nerve damage that affects eye movement and vision. In addition, lupus medications may have their own side effects.
  • Diabetes identification
    Diabetes has a strong connection to the eyes. This disease affects the small capillaries in the retina, sometimes causing them to leak blood or a yellowish fluid. An eye exam can identify this condition, called diabetic retinopathy.

For someone trying to maintain their health, this information is crucial. Earlier detection can lead to earlier treatments which, in turn, save lives, lower costs and improve people’s quality of life. But patients need to be familiar with their benefits in order to seek an eye exam from an expert and get the appropriate follow-up care. This means that employers should collaborate with providers to help employees navigate their care effectively.

Repairing a Fragmented System

Too often, the information the eye doctor finds never makes it to your employee’s primary care physician.

Because of the way the health care system is structured, vision care is often “carved out,” with no connection to the patient’s primary care team or specialists. Not only can potentially serious conditions go unreported or underreported if doctors don’t communicate, but the eye doctor might stay totally unaware of the prescriptions their patient is taking. Those medications could be affecting the patient’s vision without their eye doctor’s knowledge.

Fortunately, many organizations, including a few insurers, are moving toward a less fragmented approach. This integrated care model closes the loop, benefiting you, your workforce and your bottom line.

How Better Care Controls Costs

In an integrated model, data is shared. The eye doctor knows what medications your employee is on, and the primary care physician knows what the eye doctor has to say about the side effects. Access to more comprehensive data helps the health care team to deliver the most effective and efficient care. The result? Noticeably better outcomes and significant savings.

Consider this example: “Every time you can identify a diabetic and manage that earlier, it saves $1,500 annually per beneficiary,” Jeff Spahr, vice president of Anthem’s dental, vision, life, disability and workers’ compensation businesses, told Healthcare Finance News.

It’s not just a matter of better health and cost savings; Anthem’s latest Integrated Health Care Report found that sharing data and connecting benefits can contribute to a happier, more productive workforce.

Simply having coverage is not enough, however. An American Optometric Association case study revealed that employees who didn’t use this benefit experienced overall higher health care costs. Those with diabetes, cardiovascular disease and hypertension who lack a comprehensive vision benefit face 20%, 15% and 7% higher medical costs, respectively. Because of this, employees should be encouraged to regularly use their vision coverage.

How Integrated Benefits Work

Integrated health benefits connect an employee’s medical benefits with what are called “ancillary” benefits, such as vision coverage, through one insurance provider.

This greatly simplifies the work of benefits managers. Additionally, employees have one provider, one insurance card, and one online interface to navigate. The Integrated Health Care Report found that 99% of employers surveyed are actively integrating or considering integrating vision coverage.

Finally, pairing vision and medical coverage makes actionable, integrated data the standard, so that all health care providers can access a complete picture of an employees’ health and well-being. The end result of a proper integration of benefits is less administrative work, higher employee engagement and a future of lower costs to the organization.


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