Financial

The Financial Aspects of Myopia Management

February 17, 2025

economics

Photo Credit: Getty Images

Understanding the value of myopia management services is crucial for building confidence in discussions with patients and their families. Because most myopia management is not covered by insurance, one successful model specializes in myopia management and specialty contact lenses, operates primarily on a referral basis, and does not accept insurance. This model may raise skepticism among some practitioners, but a successful system has been established that includes a subscription plan. This plan allows patients to make monthly payments for a minimum of 12 months, making the cost more manageable. Patients receive their lenses either for the year (in the case of orthokeratology) or in three-month increments for soft contact lenses.

Systematically Pricing Myopia Management Packages
This payment structure is advantageous as it breaks down the financial burden into smaller amounts, making it more accessible. A consultation fee and a dispense fee help cover costs in the first year. Pricing for treatments is standardized, with both orthokeratology and soft contact lenses offered at the same price, while low-dose atropine is priced lower due to the absence of material costs. The first year of treatment typically involves more chair time with orthokeratology patients, while soft contact lenses incur higher material costs, balancing the overall expenses.

To determine pricing for myopia management packages, a systematic approach is employed. This involves calculating chair costs to establish a breakeven point, considering the number of follow-ups, and adding material costs. This model fosters confidence in discussing prices with patients, as transparency about costs enhances the team’s ability to communicate effectively.

Overcoming the Pricing Barrier
Despite many parents seeking myopia management, the cost can still be a barrier. Educating parents about the long-term risks associated with untreated myopia is essential, but emphasizing the emotional impact on children is often more resonant. Demonstrating potential vision deterioration using plus lenses can create a significant emotional response, helping parents understand the urgency of treatment.

When discussing fees, it is important to present the value of the myopia management program before discussing costs, framing it as an investment in their children’s eye health. Offering flexible payment options can alleviate financial concerns. Practitioners can suggest health care credit cards designed for medical services, allowing families to finance treatment at manageable monthly rates. Additionally, reminding parents about Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) can provide unexpected avenues for funding.

Communicating the Many Treatment Options
Creativity in treatment options is vital, especially when working with families that may have multiple children in need of myopia management. Off-label treatments may be less costly while still being clinically effective. Practitioners should communicate the variety of options available, including FDA-approved and off-label contact lenses, as well as eye drops that are safe and effective.

While discounting fees is not obligatory, offering a discount for additional children enrolling in a myopia management program can be beneficial. This approach reduces the time spent discussing the benefits of treatment, as the conversation can be streamlined for the entire family. Overlapping visits for siblings can also optimize scheduling and resource use.

Global Fees Simplify the Conversation
A simplified fee structure can further enhance the patient experience. Instead of detailing every cost associated with treatment, practitioners should aim for a streamlined approach. A global fee model, where one fee covers myopia management regardless of the treatment modality, simplifies the conversation. This model can be likened to orthodontic care, where a single fee is quoted for comprehensive treatment.

To establish a global fee, practitioners can analyze the last 50 patients treated, regardless of their specific needs or treatment modalities. By averaging the costs and treatment requirements, a fair and manageable fee can be determined. This approach not only simplifies the presentation for parents but can also lead to increased patient volume and overall profitability.

In conclusion, providing myopia management services is a significant opportunity for practitioners. By appreciating the value of these services and navigating conversations with families thoughtfully, practitioners can foster a supportive environment that prioritizes children’s eye health while addressing financial concerns. Simplifying the fee structure and emphasizing the value of treatment can help alleviate parental stress and enhance the overall patient experience.

To Top