Integrating Eye Care With Medical Benefits and Disease Management Programs Can Lead to Improved Health and Reduced Costs

April 23, 2013
  • Beyond diabetes, eye care practitioners can help detect and monitor more than two dozen diseases, including high cholesterol, multiple sclerosis, rheumatoid arthritis and tumors
  • Companies using an integrated approach to eye health and medical benefits, along with health and wellness programs, can reduce medical costs and improve employee health

Integrating eye care with medical benefits can help improve the management of many diseases, leading to better health outcomes and lower costs, according to a new white paper by UnitedHealthcare.

The white paper, "Integrating Eye Care With Disease Management: It's Not Just About Diabetes Anymore," demonstrates how eye care providers can play a key role in identifying people with various diseases and then partnering with primary care physicians to deliver holistic, patient-centered care. Based on an extensive analysis of prevalence, detectability and impact, the paper concluded that eye care practitioners can help detect and monitor many chronic conditions – in addition to diabetes – including several unexpected ones.

Besides diabetes, eye care providers can help detect and monitor multiple sclerosis, tumors, Crohn's disease and sickle cell anemia. For some conditions, such as sickle cell anemia, the value of eye care is in monitoring the disease. For others, such as Crohn's disease, the impact is greatest when a comprehensive eye exam helps care providers identify the condition earlier and track ocular complications caused by medications used during treatment. Eye care providers can also help monitor disease severity and progression for many conditions, including high cholesterol, rheumatoid arthritis and juvenile rheumatoid arthritis, Graves disease, AIDS and lupus.

"The eyes are the window into a person's overall health, and eye care practitioners can play a critical role in preventing and managing chronic conditions," said Linda Chous, O.D., chief eye care officer, UnitedHealthcare Specialty Benefits. "When eye care practitioners share information about diseases with patients and other care providers, it can lead to better information, better decisions and better health outcomes."

Many employers are starting to embrace this approach. UnitedHealthcare's Bridge2Health program provides integrated vision and medical benefits that support patients and health care professionals with information, decisions and outcomes. For example:

  • Eye care practitioners are encouraged to code claims with chronic condition categories. Those diagnoses are automatically referred to disease management programs for follow-ups based on the patient's needs.
  • Eye care practitioners are notified of patients with at-risk conditions during the exam authorization process, with a recommendation to include a dilated fundus exam, which uses mydriatic eye drops to dilate the pupil to gain a better view of the eye, as part of the comprehensive eye examination.
  • Patients with diabetes, diabetic retinopathy, hypertension, hypertensive retinopathy, vascular disease or high cholesterol are notified with a phone call, which is much more effective than a postcard reminder, about the importance of their annual eye exam.
  • For patients who may have chronic conditions, referrals to primary care providers or specialists are supported via specially designed forms available online to eye care practitioners.

Eighty companies representing more than 6 million plan participants have already selected this integrated approach for vision benefits to help create healthier employees, lower health care costs and increase productivity. With wellness as a core value for many companies, it is crucial to provide employees with the most advanced programs and resources that encourage a happier and healthier workforce.

About UnitedHealthcare
UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers and Medicare and Medicaid beneficiaries, and contracts directly with 780,000 physicians and care professionals and 5,900 hospitals and other care facilities nationwide. UnitedHealthcare serves more than 40 million people in health benefits and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.

Be the First to Know

Stay up-to-the-minute on the latest headlines from UnitedHealth Group.