Case Study: VSP

An eye doctor can detect signs of more than 270 systemic conditions in a comprehensive eye exam– many of which may be chronic afflictions that carry significant risk to an individual’s overall health, like diabetes and high blood pressure. (American Optometric Association). This detection can be critical in managing healthcare costs and improving patient outcomes, as determined by Human Capital Management Services Group (HCMS Group), now Workpartners.

HCMS Group combined health plan data (medical and pharmacy), lost time, and employment data, with vision data supplied by VSP® Vision Care. De-identified data regarding patients with diabetes, hypertension, and high cholesterol was pulled from this dataset and placed into one of two groups:

  1. Study Group: Patients whose condition was first identified to their health plan as a result of an eye exam (either via VSP claim or medical claim following the eye exam).
  2. Comparison Group: Patients who did not receive an eye exam prior to being identified to their health plan (e.g. medical claim, pharmacy claim).

Methods

The datasets above allowed HCMS Group to research two fundamental questions:

  1. How often is a comprehensive eye exam the first indicator of diabetes, hypertension, and high cholesterol in patients?
  2. Are there differences in health plan costs, productivity, and employment outcomes when the condition is identified through an eye exam?

For both groups, prior to the first diagnosis of the condition, there was no indication of medical care related to the condition considered. For the study group, the vision data was the first indication of a condition (see diagram). This is consistent with eye doctors routinely educating their patients about risk factors, and referring at-risk patients to their primary care physician (PCP) or other health professional for follow-up care.

vsp1

Findings

Eye Doctors Detect Chronic Conditions First

The study determined that 62% of the time, eye doctors detected signs of high cholesterol before any other healthcare provider recorded the condition. Additionally, early detection rates were 34% for diabetes and 39% for hypertension.

Fewer Hospital Admissions and ER Visits

Since eye doctors frequently identify adverse conditions first, patients often seek condition-specific care sooner than they might have otherwise. This can lead to reduced health costs and improved workplace productivity in the future.

The study showed that the patients identified through an eye exam entered the health care system with fewer complications and comorbidities, and experienced lower rates of inpatient admissions and emergency room visits compared to patients who may have delayed a preventive vision or physical exam.

vsp2

 

Additional Benefits of Early Identification

HCMS Group found that the study group patients required fewer medications to control their condition and had higher rates of preventive care visits relative to the comparison group. This finding suggests that early identification leads to improved health and lifestyle habits, and a greater focus on preventing health deterioration.

 

Lower Costs Through Earlier Identification

For each group, the disease-related medical costs and job performance data were analyzed over a four-year period following identification in the first year of the study.

On average, the study group incurred:

  • fewer health plan costs,
  • fewer lost-time costs (short/long term disability, workers’ compensation indemnity costs),
  • had a lower job turnover rate, and
  • lower rates of emergency room visits and hospital admissions

vsp3

 

The study found that for every initial $1 spent by clients on exam services, they saved $1.45 over a four-year span. Employers in the study saved a total of $13.1 million over four years.

This translates to a 145% ROI on the initial dollar investment.

HCMS Group found that employees in the study group were generally healthier, suggesting that comprehensive eye exams are an important factor in identifying chronic conditions. This leads to the conclusion that early identification through an eye exam leads to substantial savings, including improved productivity and lowered healthcare costs.

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