1. Contact Lens for the Non Traditional Patient Shane R. Kannarr, OD Kannarreyecare.com

2. How do we break this cycle? Be proactive not reactive – Utilize trials—in your dispensary – Fit Fees – Partnering with your vendors – Partner with your staff—I think the most important

3. The Contact Lens Market: Is there Profitability in contact lenses: First lets look at the initial visit: – Fit fee: $25 + $55 contact lens profit – Profitability on an annual supply: – Assume 4800 full exams a year (100 exams a week/48 weeks a year) – Assume (45%) are contact lens wearers (2160 contact lens exams) – Profitability to the practice per year ($134400 at 35%) ($172800@ 45%) Difference $38400 seeing the same number of patients – DO YOU WANT TO GIVE UP THAT Profit????

4. 6 year life span of a patient (Jerry Hayes, OD “Practice Profit:The Case for Contacts” 6 Year CL Revenue (119/yr) 6 year Number of full exams Median exam fee Revenue 6 year Spectacle Revenue 6 year value of a patient Contact and Spectacles $7144$556$458$1728 Spectacles only 2.4 Purchase cycle ($229) 03$330$573$903

5. Kicker to this equation This applies to full and part time contact lens patients So the question: How do we convert non wearers to wearers? – What impact would this have on our practice Assume 4800 Exams a year Change spectacle lens exams from 35% to 45% (add 2 boxes daily+refit fee) Increase of 480 contact lens patients Increase in exam gross revenue:$155.00 ($74,400) Increase in profitability:$68.00 ($32640)

6. The Contact lens Market place Has really been at a constant the last 10-15 years 150 million with correction 36 million wearing contacts (24%) (2.8M in and out) Why is that? – Comfort – Changes in Contact lens technology – Aging population – PRACTITIONERS – STAFF

7. How do we break this cycle? Be proactive not reactive – Utilize trials—in your dispensary – Fit Fees – Partnering with your vendors – Partner with your staff—I think the most important

8. Contact Lenses by Modality Monthly modality – Advantages/Disadvantages Two week modality – Advantages/Disadvantages Daily disposable – Advantages/Disadvantages Others – Advantages/Disadvantages

9. How do your numbers stack up How does changing the numbers impact you: Industry average on percentage 2 weeks 36% Monthly 42% Quarterly 4% Yearly 3% Daily 13%

10. How do we justify extra fees for contact lens fits: Chair time Additional testing Does the patient understand the fee? – And its value

11. Perceived Compliance 2 week modality52% Monthly Modality67% Daily77%

12. Contact Lens Fits by Materials Hybrid Lenses25% Silicon66% GP8% Hybrid1%

13. Toric Lenses What is your practice attitude? – When are toric lenses indicated? – Professional fees – Options available (what is an average range) – What about difficult to fit patients Fitting low cylinder (do -0.50 matter) What about masking?

14. Impacting the numbers Current average practice fits 23% toric 47% of the population of =/>.75D (24% are in one eye) If I change this how will impact my numbers What does it do to my patient satisfaction?

15. Presbyopic patients Are you meeting the needs of these patients? – 35-49 years of age 63.78 million – 50-69 years of age 50.64 million – 114.42 million people What choices are available? – Monovision – Bifocal (10-12%) (roughly 3.6M out of 100M Untapped???) – Contacts and readers

16. Expectations What are “proper expectations” How do establish those expectations? – What roles does the practitioner play – What roles does the staff play – Avoiding “the downward spiral” – Will patients remember the established expectations

17. Common Multifocal contacts Biofinity Airoptixs Purevision Proclear EP lenses Acuvue

18. ARE YOU CRAZY!!!!! Toric Multifocals: Proclear, UCL – Do they work? – How well do they work? – What is an appropriate professional fee – What are “reasonable expectations”

19. Insurance: How does insurance benefit your practice? You have to know Chair time Simple calculation (revenue (explanation/hours open per year) – Revenue all expenses including docs base salary+benefits – Should the dispensary be separate Does insurance benefit the patient? Do you maximize the insurance benefits to both?

20. contact lens options to consider RGP’s Piggy back fits – When to use a higher modulus Hybrid lenses

21. Specialty contact lens fit fee Codes Aphakia/Nystagmus/Nystagmus/Corneal Transplant/corneal dystrophies/Albinism/Coloboma resulting in Aniridia Anisometropia-=/> 3D in any meridian based on spec Rx High Ametropia- =/-10D in any meridian based on spec Rx Irregular Astigmatism= different parts of the same meridian with different curvature or principal meridians that are not perpendicular

22. Specialty contact lens Fees Contacts are covered in full for these patients Scleral lenses V2530 or V2531 Hybrid ARE NOT SCLERAL v2599 (must include type of hybrid lens manufacturer and brand) Piggy Back (will pay soft and hard use a case number at initial visit) Failure to complete info will result in reimbursement at a lower level

23. Contact Lenses with Specs over the top High Ametropia 10D or greater Presbyopia Accommodative disorder Binocular Function Different prisms for distance and near vision

24. Specs over glasses Request a case number at same time as contact lens authorization or within 30 days Specs cannot be plano

25. Reimbursement 85% of U&C for contact lens services and U&C for materials up to allowed amount Examples 2 weekDaily Sphere$500$573 Toric$650$659

26. The Role of Rebates Why rebates? Can you differentiate your practice with them? What is the process like for you patients?

27. How do we compete with: Big box retailers: On line sales Insurance companies

28. Pricing Contact lens materials Consider your patients perspective! Remember we look at profit per patient not individual unit sales The idea of a multiplier no longer works Volume v. per unit sales

29. Creating Annual Supplies Do you include a discount? Most important how are annual sales promoted in your office? Do your patients see the benefit?

30. Inventory When does it make sense: Is it the practitioners or the manufacturers advantage? How much is enough?

31. Distributors What are the options? Advantages Disadvantages Where does their profit come from?

32. Marketing in the future Internet Face Book Third party assistance Media Yellow Pages WORD OF MOUTH