A Dry Eye Center of Excellence: Does it Add Up for Your Practice?
By Marguerite McDonald, MD, FACS and Perry Fumuso, MBA
You can make plenty of calculations to help you arrive at an answer to that question.
But let’s start with one simple number: 4.88 million. That’s how many people – 1.68 million men and almost twice as many women – are currently walking around with itchy, irritated, chronic dry eyes, according to estimates by the American Academy of Ophthalmology. Dry eye is a condition that worsens with age, and the country’s over-50 population is projected to grow substantially in the coming decades. And with it, the number of people with the condition is likely to soar as well.
Moreover, while you can provide effective treatment to relieve symptoms, dry eye is a chronic disease. That means you’ll have the opportunity to build long-term relationships with your dry-eye patients, and potentially to treat them for some of the several conditions that commonly occur concurrent with dry eye, as well as any other conditions that may develop in an aging patient.
Here’s another number to consider: 1,500. Ophthalmology industry expert Bruce Maller estimates that, conservatively, a practice of two to three ophthalmologists could easily attract 1,500 new dry eye patients in the first year, with only a modest marketing effort.
In our practice, we devised some easy, effective ways to get the word out to existing patients about our Dry Eye Center of Excellence. In your practice, you can easily replicate these strategies:
• Include an announcement of the opening of your dry eye center of excellence in all invoices.
• Distribute buttons inviting patients to “Ask me about dry eyes!” to your techs and have them wear them in the office.
• Hang dry eye related posters in the lobby and in each exam lane of your office.
Those minimal investments should begin to pay off in relatively short order. Assuming your practice attracts 1,500 new dry eye patients, Bruce Maller calculates that you can expect the following revenue from basic dry eye treatment – based on 2017 Medicare reimbursement rates:
• Comprehensive new patient exam: $150
• Follow-up exams at one, three, and 12 months: $74 each
• Osmolarity testing: $203
That brings your total annual revenue per patient to $575. Multiplied by 1,500, that amounts to gross dry eye revenue of $862,500.
If you add in only two punctal plugs, a common dry eye treatment, that brings in another $224, for a total of $799 per patient. Most of my patients, however, end up with four, which would mean even more revenue. Of course, you will need to make some equipment investment in order to perform proper diagnostic tests and administer dry eye treatments. The good news is that most of this equipment is useful for diagnosis and treatment of numerous other conditions—and may already be in your office.
The OCULUS Keratograph® 5M is a particularly useful tool for accurately diagnosing dry eye and documenting the findings. It provides a Placido disc-based topographer, meibography, and five additional ways to analyze the tear film. Based on our practice experience, you can anticipate the following return on investment for that equipment:
PROKERA® biologic corneal bandages are made of amniotic membrane suspended on a thin plastic ring; they are used to treat moderate to severe dry eye. They also help heal ocular surfaces damaged by a long list of other conditions that you’re likely to see, including keratitis, recurrent corneal erosions, filamentary keratitis and neurotrophic conditions.
Offering treatment with PROKERA® is likely to produce the following revenue:
The numbers are starting to add up, and there are plenty more. Stay tuned for more financial data on a dry eye center of excellence in next month’s newsletter.
Marguerite McDonald, MD, FACS, with OCLI on Long Island, NY, is clinical professor of Ophthalmology at NYU Langone Medical Center, NY, and clinical professor of Ophthalmology at Tulane University Health Sciences Center, New Orleans, Louisiana.