Medicare reimbursements for physicians are at their lowest level in 20 years, while inflation and wages are on the rise, putting many ophthalmic practices in a financial bind. The American Society of Ophthalmic Administrators (ASOA) held a panel discussion Saturday during the ASCRS meeting in Boston to discuss strategies by which practices can improve their bottom lines. The discussion featured Maureen Waddle, MBA, senior consultant at BSM Consulting in Wilton, California; Patti Barkey, COE, the chief executive officer of Bowden Eye Associates in Jacksonville, Florida, and the immediate past president of ASOA; and Carrie Jacobs, COE, executive vice president of operations at Chu Vision Institute in Minneapolis and ASOA’s president-elect. Some highlights from the discussion include:

• Practices should charge a “no-show fee” when patients skip scheduled appointments or consultations. “Those spots on your schedule are valuable,” says Barkey. “The fee doesn’t cover what you would have made from the visit.” Jacobs agreed. “We had a 30 percent no-show rate for cataract consultations, but since we implemented a $50 no-show fee that has been reduced to 5 percent,” she said. When asked how to collect from new or prospective patients, she answered, “Tell them up front there is a fee, and get their credit card information when they schedule.”
• Whenever possible, technology should be used for mindless tasks to free employees so they can do more important work. For example, Jacobs suggests investing in an automated system that will text patients on a waiting list any time the practice has an unexpected cancellation to try to fill the spot. If the first patient contacted says no or doesn’t respond within a certain time, the next person on the waiting list can be contacted. Administrators should focus on efficiency, as well as accountability, said Barkey.
• Testimonials from satisfied patients can be a powerful marketing tool. “The best way to get a patient testimonial is for the doctor to ask — especially after they are happy with the result of a procedure,” said Jacobs. “Have a release form available for them to fill out if they say yes, and snap the photo right then.” Waddle agreed, saying, “Customer service is still the number one marketing tool — 50 percent to 60 percent of our patients still come from word of mouth.”
• Practices should develop strategic growth plans to increase revenue by offering premium services. Bowden Eye has been successful by focusing on treatment of dry eye disease, said Barkey. “Studies indicate there are 36 to 60 million dry eye patients in the United States, and most are not being treated,” she said. Bowden Eye offers premium packages that include several different modalities, from blephex and gland expression to intense pulsed light (IPL) treatments. “The revenue from this is tremendous — right now it’s about 20 percent of our practice revenue,” she says. Chu Vision is having similar success by promoting the Light-Adjustable Lens (RxSight), says Jacobs. “Patients are so happy with the outcome that we keep increasing our fee,” she says. “You can have a tech or an optometrist do the adjustments, but we’ve found that people prefer for the surgeon who implanted the lens to also do the light treatments, and they will pay more for that.”