Advocating for Major Changes in Vision Care Disparities Across the US
VisionServe Alliance (VSA) members share a deep commitment to addressing the disparities in vision care impacting millions of adults. Therefore, VSA is actively advocating for policy changes to address the significant disparities in US ophthalmic care and rehabilitation services through participation in the ITEM Coalition Low Vision Committee, Vision Health Advocacy Coalition (VHAC) Low Vision group, the Disability and Rehabilitation Research Coalition (DRRC), the Aging & Vision Loss National Coalition (AVLNC), and the Medicare Exploration Project, which addresses access and funding issues.
Recent Studies Highlight the Lack of Access & Equality
A recent NIH-fundedHealth Affairs study highlights significant gaps in Medicaid vision coverage for US adults, with 6.5 million Medicaid enrollees (12%) living in states without coverage for routine adult eye exams and 14.6 million (27%) residing in states without coverage for eyeglasses. This analysis of 2020 Medicaid enrollee data and 2022-23 coverage policies revealed that 20 states did not cover glasses under fee-for-service Medicaid,12 of these also did not cover eye exams, seven states had no coverage for exams or glasses under fee-for-service and managed care policies, and thirty-five states did not cover low vision aids such as magnifiers and loupes. Big Data Project Reports further elucidate these issues and the adverse impact of vision loss on chronic health conditions and all social determinants of health.
Medicare Gaps in Vision Care Service & Coverage
Although children are entitled to receive vision services under federal law Vision and Hearing Screening Services for Children and Adolescents | Medicaid, states determine Medicaid coverage for adult eye exams and eyeglasses, which creates unequal access to these vital services for adults. Access issues are not limited to Medicaid enrollees; older Americans with Medicare Part B and Medicare Advantage plans also face challenges accessing vision care. When a person successfully navigates these broken systems and receives surgery, medication therapy, or glasses to correct a refractive error but still experiences significant vision loss, they are again left to navigate an even more complex system to receive vision rehabilitation services.
Importance of the Medicare Exploration Project
VisionServe Alliance believes that addressing the disparities in vision care and rehabilitation services requires a multifaceted approach that includes policy changes, increased funding, and innovative service delivery models. We are committed to leading these efforts and ensuring that all individuals, regardless of socioeconomic status, have access to the vision care they need to vastly improve their quality of life.
During Phase I of this vital initiative, we explored the expansion of vision rehabilitation services and the feasibility of housing the practice of vision rehabilitation in the healthcare system to generate incremental funding, including comprehensive wraparound vision rehabilitation services through Medicare (CMS) and other healthcare providers.
VisionServe Alliance is now embarking on Phase II, focusing on increasing service accessibility and addressing funding limitations, professional shortages, and logistical challenges in delivering in-home services. Initial support includes a transformative project grant from the Lavelle Fund for the Blind, plus added financial support from our partners and members.
Key Medicare Exploration Project Phase II Goals:
Expand the Pool of Professionals Providing Services
Using a specific service model, we seek to integrate Occupational Therapists to expand the pool of vision rehabilitation providers while preserving the vital role that Vision Rehabilitation Therapists and Orientation and Mobility Specialists play in providing comprehensive vision rehabilitation services. Occupational Therapists (OTs) who deliver services qualifying for Medicare billing will be trained to deliver select vision rehabilitation services efficiently. This will allow the person living with vision loss more hours of direct vision rehabilitation services and increase agency revenue through Medicare reimbursements.
Access to Diversified Funding Streams
To open diversified funding streams for agencies, we will provide training opportunities for BVI agency administrators to access alternative community-based Medicare and Medicaid waivers and programming. Training webinars will equip members with essential knowledge and strategies to further develop the services they offer to the expanding pool of older Americans living with vision loss.
Develop Evidence-based Research to Support Increased Funding
VisionServe Alliance will commission an epidemiology study that seeks to provide evidence that vision rehabilitation services significantly improve the lives of people living with blindness and low vision. Anecdotally, we know that vision rehabilitation services can reduce health inequities and minimize the adverse effects of vision loss across all social determinants of health. In conjunction with the Big Data Project, this comprehensive meta-analysis of current vision rehabilitation clinical practice will highlight the benefits of vision rehabilitation, allowing the BVI community to advocate for more funding.
Support this Critical Industry-wide Initiative
VisionServe Alliance is offering to lead and administer this industry-wide initiative, which would be difficult for any organization to undertake alone but is something we can accomplish together. Please download a detailed Phase II project overview embodying our collective dedication, shared vision, and unwavering commitment to vastly improving the quality of life of millions living with blindness and low vision.
Your contribution, no matter the amount, is crucial to the success of this project. Please join us by pledging a gift to be paid anytime between now and the end of December. Call me at (314) 961-8235 or email LeeN@VisionServeAlliance. We would also appreciate suggestions of other organizations and individuals who may be interested in providing support to ensure this campaign’s success. You can also click here to donate today.
Together, we continue to create a stronger future for vision rehabilitation services!