Research

• Eye and vision disorders are the second most prevalent health problem affecting over 120 million Americans with employers spending more on vision and eye disease annually than on breast cancer, lung cancer or HIV.

• Eye and vision care serve as an important point of entry into the health care system.

• This analysis revealed dramatic differences in medical claims cost for a moderate size employer of over 10,000 employees and dependents were analyzed.The average annual expenditure per member for those not having an eye exam was 62% higher than those who did have an eye exam.
  For those experiencing a hospitalization of 1 or more days, the average length of stay for those having an eye exam was 5.3 days verses 8.2 days for those not having an eye exam.
  Expenditures for those hospitalized were 41% lower for those having an eye exam vs those who did not.
  

SUMMARY

Eye Care Professionals (ECPs) and their services offer a unique solution to employers in their drive to improve the health of employees and their dependents. The comprehensive eye and vision examination is an essential component in the evaluation of an individual’s overall health status. As such, the eye exam should be positioned as an essential component in an employer’s health and wellness program. For many patients requiring systemic or other health related care services, eye and vision care serve as an important point of entry into the health care system.

Optometrists provide more than two thirds of the primary eye care services in the United States Optometrists are community-based, doctoral-level health care providers who diagnose, treat and manage diseases and disorders of the eye, visual system, and associated structures. These eye care professionals, through guidelines developed by the American Optometric Association, provide important disease prevention and health promotion activities during a comprehensive eye examination.

A recent analysis of health claims data shed light on the potential for eye care professionals to help improve the health status of the employer’s beneficiaries. Medical claims data for a moderate size employer of over 10,000 employees and dependents were analyzed.

The analysis was performed on a subset of members participating in medical coverage for a three year span with a focus on those at high risk and corresponding high cost for the employer. Three hundred eighty-nine (389) individuals were identified with a confirmed diagnosis of both diabetes and hypertension. The analysis included an assessment of those members within this cohort that had an eye exam and those who did not.

The analysis revealed dramatic differences in overall cost to the employer:

• The average annual expenditure per member for those not having an eye exam was 62% higher than those who did have an eye exam.

• For those experiencing a hospitalization of 1 or more days, the average length of stay for those having an eye exam was 5.3 days verses 8.2 days for those not having an eye exam.

• Expenditures for those hospitalized were 41% lower for those having an eye exam vs those who did not.