Financial

The Economics of Myopia Management

February 3, 2025

By Wes McCann, OD, MBA

economics of myopia management

Photo Credit: Dreamstime Photos

As myopia rates continue to rise globally, providing myopia management in an optometric practice is becoming not only a valuable service for patients but also a potential revenue stream for clinics. However, implementing this service necessitates a comprehensive understanding of the financial commitments involved. From overhead costs to patient fees, establishing a profitable myopia management program requires careful consideration of the economics. The key areas that ensure myopia management is both feasible for patients and sustainable for your practice include chair cost, fee structures, marketing, and return on investment (ROI).

Overhead Costs of Delivering Myopia Management
Offering myopia management brings specific overhead costs that should be calculated into your clinic’s financial model. Key components include:

  1. Chair Cost: In a typical clinic, the chair cost — covering utilities, staff time, and operational expenses — averages $150-$200 per hour. Myopia management appointments may be longer due to in-depth consultations, but you should also consider the total number of appointments, as many patients will require a minimum of two visits annually. Factoring the number of follow-ups over a year provides a more accurate chair cost estimate per myopia management patient. For example, if a patient requires two 15-minute visits annually, your chair cost per visit could amount to $50 per visit.
  2. Equipment Lease Costs: Effective myopia management relies on specialized equipment, such as a biometer, to track axial length changes. Leasing a biometer typically costs around $1,000 per month, an important consideration for any practice hoping to offer high-quality myopia management services. Clinics offering orthokeratology may also need a corneal topographer, which adds to monthly costs. Together, these tools represent a significant investment that must be balanced by adequate patient volume.
  3. Training Costs: Trained staff are essential to delivering consistent, high-quality care. Initial and ongoing training for optometric assistants in biometry measurement and patient education can range from $300 to $1,000 per staff member. Training helps to minimize optometrists’ workload by enabling support staff to handle routine tasks and follow-up care, improving clinic efficiency.

Determining Your Myopia Management Clinic Fee
Setting appropriate fees is essential to balancing clinic revenue with affordability for families. Consider these options:

  1. Fee-for-Service Model: This model charges patients for each individual service, from consultations to biometry scans, contact lens fittings, or atropine therapy. While transparent, this approach may lead to resistance, as families may feel burdened by each separate charge. Fee-for-service can work well for smaller or one-time visits but may deter patients needing consistent follow-up.
  2. Global Annual Fee Model: A more streamlined approach, the global annual fee, encompasses the majority of myopia management services for a flat yearly rate, providing families with predictable costs. However, higher annual fees can lead to sticker shock, especially if patients feel they are paying for services they may not use.
  3. Hybrid Model: A practical middle ground can be a hybrid approach, where an annual fee covers core management services, and certain treatments (e.g., OrthoK, contact lens fittings and teaches, or atropine therapy) are billed separately based on patient needs. This way, families benefit from cost certainty while maintaining flexibility in their treatment options.

Marketing Myopia Management
Educating patients about myopia management early — ideally before they enter the exam room — is key to fostering acceptance and increasing enrollment in your program. A well-rounded marketing approach, both internal and external, can ensure families are aware of the service:

  1. Internal Marketing: Clinics should utilize informational posters, brochures, and handouts to introduce patients to myopia management during routine visits. Additionally, staff can be trained to discuss the risks of untreated myopia and the benefits of early intervention. Email marketing is also a powerful tool that allows you to reach patients with information and reminders about myopia management, upcoming consultations, or seasonal promotions. Marketing via email ensures that families are already aware of the service before their appointments.
  2. External Marketing: Raising awareness outside the clinic helps build familiarity and trust. Social media, email newsletters, and community outreach are effective ways to inform families about myopia management options. Partnering with local schools or pediatricians can introduce the concept to a broader audience and ensure that families understand its importance. External marketing positions your practice as an expert in myopia management and helps establish your brand.

ROI on Equipment Investment
Investing in specialized equipment is necessary for myopia management but requires a strategic approach to ROI.

In this scenario, consider:

  • Chair Cost: $200 per hour
  • Exam Time: 15 minutes per myopia management visit, translating to a $50 chair cost per visit
  • Equipment Lease: Biometer lease at $1,000 per month
  • Patient Volume: 10 myopia management patients per month, each enrolled in the program
  • Annual Fee: $350 per patient, paid once for the year’s myopia management program
  • Associate Compensation: 21% of gross revenues Expenses and revenue:
  1. Annual Patient Revenue: With an annual fee of $350 per patient and 10 patients enrolled, the clinic generates $3,500 per month in gross revenue.
  2. Associate Compensation: At 21% of gross revenue, the associate’s compensation would be:
    0.21 × $3,500 = $735/month
  3. Chair Cost for Annual Visits: Each patient has two visits per year, resulting in a $100 chair cost per patient annually ($50 per visit). For 10 patients, this totals:
    10 × $100 = $1,000/year or $83.33/month
  4. Equipment Lease: The biometer lease cost remains $1,000 per month.
  5. Total Monthly Overhead Costs: Adding up the associate compensation, chair cost, and equipment lease: $735 + $83.33 + $1,000 = $1,818.33/month
  6. Monthly Profitability: Subtracting the total monthly overhead from the gross revenue:
    $3,500 − $1,818.33 = $1,681.67/month

Summary of ROI Example
In this adjusted scenario, the clinic would retain approximately $1,681.67 per month after covering associate compensation, chair costs, and equipment lease expenses. To break even on the biometer investment, the clinic would only need to maintain 10 patients enrolled in the program consistently. Expanding the number of patients enrolled would further increase profitability, allowing the clinic to cover additional overhead or invest in other areas of the practice.

This example highlights how a myopia management program, even with a moderate annual fee, can be sustainable and profitable by carefully managing patient volume, overhead, and compensation.

Additional Considerations for Myopia Management Economics

  1. Insurance and Payment Plans: Since insurance coverage for myopia management is rare, providing flexible payment options can help make it more accessible for families. Partnering with health care financing companies or offering installment plans can make the annual fee manageable for a broader patient base, encouraging higher enrollment.
  2. Optimizing Staff Time: To maximize profitability, optometric assistants must handle as much of the myopia management program as possible. By delegating routine measurements and counseling to trained staff, optometrists can focus on consultations and diagnosis, optimizing patient flow and chair time.
  3. Patient Retention and Referrals: Families who engage in myopia management programs are likely to remain loyal to the practice, especially if they see results. This retention is valuable for long-term profitability, as myopia patients may continue routine eye care with your clinic and refer family or friends, broadening your patient base organically.

Conclusion
The economics of myopia management involve careful planning and a consistent patient volume to cover costs and generate profit. By combining thoughtful fee structuring, strategic marketing, and effective resource allocation, clinics can develop a sustainable myopia management program that addresses patient needs while boosting clinic revenue. When executed well, myopia management provides optometrists with an opportunity to diversify their services and establish their practice as a leader in pediatric eye care, fostering trust with families and ensuring long-term clinic success.

 

Dr. McCann attended Western University and Nova Southeastern University where he earned three Honours Bachelor of Science degrees, an accelerated MBA, and Doctorate of Optometry. Dr. McCann owns 12 practices in Southwestern Ontario. He has been a speaker at the Canadian Dry Eye Summit and THE Myopia Meeting and lectured at hundreds of other conferences on contact lenses, ocular disease, dry eye, pharmaceuticals, and medical equipment. He is a consultant and/or speaks for Johnson & Johnson, Bausch + Lomb, Labtician, Thea, Oculus, Clarion, Zeiss, Otto, Luminus, Neurolens, Nikon, and Sun Pharma. He has taught clinical externs from the Waterloo School of Optometry, has served on the Board of Directors for the Ontario Association of Optometrists from 2016-2018, and he is currently on the Board of Directors for Eye Recommend, as well as a Director on the College of Optometrists of Ontario. He has been published in numerous journals including Review of Optometry and Review of Myopia Management. In 2017, he was a recipient of the Top 20 Under 40 Award that recognizes business achievements and community involvement in London, Ontario. In 2024 he was awarded the Contact Lens Institute Award for Contact Lens Culture, recognizing his impact on fostering contact lens cultures that enhance patient experiences and business success.

 

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