Adequate Eye Care Access Lacking In Much Of Western, Central Mass And Rural Areas
Measure modernizing eye care laws would help patients in western ma, save consumers and state money
In July, doctors of optometry, colleges of optometry, and other members of the eye care community testified on a measure that would modernize Massachusetts' eye care laws, save Medicaid $20 million annually, and address the disparity of care in Western Massachusetts and other rural parts of the state. In testimony in front of the Joint Committee of Ways and Means and Joint Committee on Health Care Financing, the coalition described how 49 states and the Federal VA medical system allow optometrists to treat glaucoma and prescribe limited oral medications for eye infections, and have been doing so for up to 40 years. Massachusetts is the only state that does not, requiring the expense and inconvenience of a visit to a specialist ophthalmologist to treat conditions routinely and expertly handled by optometrists everywhere else.
"Optometry locations outnumber ophthalmology offices in Western Massachusetts by a 10 to 1 ratio," said Dr. Matthew Forgues of Worcester, President of the MSO. "With only 325 ophthalmologists in Massachusetts and only a few dozen in the west, this means higher expenses and extensive, unnecessary travel and inconvenience for patients with glaucoma or other eye infections that are treated by optometrists in all 49 other states." Dr. Forgues also noted the irony that exists in Western Massachusetts given that patients at the Northampton VA Medical Center can be prescribed oral anti-infectives and glaucoma drops by optometrists practicing there but their friends and family members can't get the same care from a private optometrist a few miles away. "It just doesn't make any sense, which is probably why we are the only state with an outdated law like this," he continued.
Legislative support for the measure has been building throughout 2017. Bills H. 1169 (Rep. Patricia Haddad), H. 2463 (Rep. Brad Jones), S. 1242 (Sen. Michael Moore), and S. 1190 (Sen. Sal DiDomenico) were filed early in the year and achieved major bipartisan support. The Senate included it in its budget, and Governor Baker included it in his Medicaid reform package. All of the bills and amendments would change Massachusetts' antiquated laws and ensure consumer choice and equal access to eye care.
Bringing the Commonwealth up to the national standard is supported by the Massachusetts Society of Optometrists, the Federal Trade Commission, the U.S. Department of Justice, the Massachusetts League of Community Health Centers, and Massachusetts' two schools of optometry as it is a common-sense reform that saves money and provides access to the more than 1500optometrists in Massachusetts for patients with glaucoma and eye infections.
Under current law, doctors of optometry screen all patients for glaucoma and eye infections, but if either condition is detected they must then refer the patient to an ophthalmologist rather than simply prescribing drops that would treat it. This forces the patient to waste time on an unnecessary visit to an ophthalmologist, which can take days or weeks, and in Western Massachusetts and parts of Central Massachusetts require driving a great distance to find care. Patients then likely pay an additional co-pay, and Medicaid pays a higher, specialist rate for the same care. If the same patient simply crossed the border into Vermont or Connecticut, their optometrist could take care of everything in one visit.
The Massachusetts State Senate passed the legislation seven times in recent years, but it has not passed in the House. In a letter to the House in 2016, the Federal Trade Commission and U.S. Department of Justice wrote that patients in Massachusetts could "experience increased access to care, more choice in how their care is delivered, and more cost-effective treatment."
An expert study by former Massachusetts Director of MassHealth, Tom Dehner, and Missy Garrity of Health Management Associates found that allowing optometrists to treat glaucoma and other eye infections would save $19.6 million per year for MassHealth, the state's Medicaid program.