Jim Brocato, President & CEO, Coherent Eye Care
Let us get to the heart of America’s diabetes crisis. Based on overall population growth projections, the Center for Disease Control predicts that between 2018 and 2050, the number of Americans with diabetes will grow more than five-fold to 161 million. This means that one in three Americans will have type 2 diabetes. The manifestation of diabetes over a period of 15 years will cause some degree of retinal damage for patients with type 1 or type 2 diabetes. As such, the studies put one in five Americans, about 65 million people, at the risk of diabetic retinopathy and permanent vision loss.
Meanwhile, with the advances in treatment options, including early detection, 95 percent of vision loss due to diabetes is preventable. Although an optometrist and ophthalmologist can identify diabetes, high blood pressure, or high cholesterol through a dilated annual eye exam, less than 50 percent of the patients receive a dilated eye exam annually. Set against this backdrop, Coherent Eye Care, a company that builds and manages clinically integrated eye care networks, is focused on eliminating preventable vision loss by partnering with optometry, ophthalmology, primary care physicians (PCPs), and health care delivery systems. “Our mission is to optimize the vision and health of our patients by delivering value-based comprehensive eye care,” says Jim Brocato, President and CEO of Coherent Eye Care. Coherent’s population eye health strategy takes a broad approach, focusing on prevention, early detection, patient engagement, improved access to care, and care coordination and contracting to impact the entire eye care ecosystem.
Coherent is structured in a way to provide health insurance companies and providers with resources focused on value-based eye care services. The shift in the healthcare landscape toward delivering better health outcomes at a lower cost has resulted in more incentives for health systems and providers to explore data analytics and other population eye health management measures for patient benefits. Despite continuous efforts by Accountable Care Organizations and Medicare Advantage Plans, attaining and improving quality scores for diabetic eye exams (Star and HEDIS ratings) continues to be a challenge. A large part of that is due to how vision and medical services are siloed. Coherent brings these two services together under one structure in a clinically integrated eyecare network (CIEN). “Our CIENs,” says Brocato, “are strategically positioned to help health systems, health plans, and Accountable Care Organizations implement patient-centric, data-driven clinical pathways designed to ensure and predict optimal clinical outcomes with the lowest cost of care, while also improving HEDIS quality measures performance.”
CIENs involve high-value providers and eye health systems strategically collaborating to achieve the “Quadruple Aim.” This means that whether it is a health plan, IPA, ACO, or employer, Coherent can help improve the individual experience of care, health of populations, and clinician experience, while reducing the per capita costs of care. “Our technology platform, coupled with robust analytics, simplifies and automates the time-consuming manual tasks of reporting to achieve optimal patient care,” explains Brocato. “This, in turn, results in improved STAR and HEDIS® performance.”
Our ClENs are strategically positioned to help health systems, health plans, and Accountable Care Organizations implement patient-centric, data-driven clinical pathways designed to ensure and predict optimal clinical outcomes and cost-of-care, while also improving HEDIS quality measure performance
Coherent’s integrated communication platform provides secure electronic messaging, seamless health information exchange, clinical dashboards, and flexible reporting options for Centers for Medicare & Medicaid Services (CMS) and Accountable Care Organizations while leveraging certified electronic health records technology and qualified clinical data registries.
Elaborating on their offerings and resources, Brocato says, “Our CIEN comprises value performance committees including optometry, sub-specialists in ophthalmology, and PCPs, all working together to improve the referral process and care coordination.” Contrary to the vast majority of contracting at the primary care level, Coherent is leading the charge with value-based contracting at subspecialty levels. Along with a CMS-approved qualified clinical data registry for quality reporting, the services include a call center of dedicated care coordinators for patient engagement, education, scheduling eye exams, and follow-up with PCPs. This closes all communication and care gaps and provides a complete package of health management. “Our tools can be customized to cater to a specific payor or marketing community. We provide a comprehensive vision care management program for small- to medium-sized health plans lacking the resources to optimize the vision and health of patients,” says Brocato.
Coherent’s drive toward quality care and early access to screening and prevention revolves around annual eye exams and preventative care, reducing the cost for patients to access it by eliminating factors like copays. Moreover, cloud-based referral management systems are used to create, share, and transfer authentic clinical data necessary for all providers on a patient’s care team. Coherent’s referral platform integrates clinical data from different platforms and provides access to various stakeholders through website capabilities. The clinical and practice management data—both from the ophthalmology and optometry systems—are extracted and shared among all providers using the cloud-based platform. “We have integrated a primary care direct messaging capability in the eyecare space on our platform,” says Brocato, “which manages the care coordination and communication electronically. This ensures that all stakeholders are included in the patient interaction, automatically closing the diagnosis and treatment gap.” Through care coordination, optometrists and ophthalmologists can partner with PCPs to ensure that the patient is seeing the right doctor at the right time.
Finally, concerning implementation, Coherent directly communicates with a PCP when a patient is identified as a diabetic and further engages the optometrist, ophthalmologist, or other specialists accordingly. “One of the biggest challenges is getting patients to understand the importance of an annual eye exam,” says Brocato. It is estimated that over 40 percent of diabetic patients never see an eye care provider. A key part of our brand promise is to deliver quality value and access. Coherent delivers on this promise by developing and implementing a customized population health program that addresses the specific needs of the health system and the patient population. This includes understanding and addressing social determinants of health and the importance of patient engagement. Through this wide range of services and collaboration with health systems, Coherent is able to deliver value-based population eye health services!