Ophthalmic Innovation 2016 - "A View From The AAO" Presenter: David Parke, II, MD, CEO Powered by: Healthegy For more ophthalmology innovation Visit us at www.ois.net

1. Ophthalmic Innovation 2016:
A View from the AAO
David W. Parke II, M.D.
CEO
American Academy of Ophthalmology

2. The Big Three
• V2V: “VOLUME TO VALUE”
• A2A: “ANECDOTES” TO “ANALYTICS”
• P2P: “PATIENTS TO POPULATIONS”
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3. V2V: Health Care Payments
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VALUE =
QUALITY
COST
VALUE = healthcare outcomes achieved
per dollar spent

4. Measuring the ‘Right Stuff’
• What is the most important factor in surgery?
1. Judgment as to whether to operate or not
2. Which procedure to perform given clinical factors
3. Intraoperative technical skill
4. Whether guidelines followed for antimicrobial prophylaxis
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5. MACRA
 Fundamentally changes the way Medicare
determines and updates payments to physicians
(and hospitals and ASC’s)
 Goes into effect January 2017
 Final rules this week
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6. Impact for Industry
• Within three years, 30% of each ophthalmologist’s individual score
will be based on “resource use” or total cost
• Cataract surgery: site of service (ASC vs HOPD)
• Retina: choice of anti-VEGF agent
• Impact on physician payment and behavior:
• up to 9% of total Medicare payments at risk
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7. A2A: Anecdotes 2 Analytics:
IRIS Sept 2016
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0
20
40
60
80
100
120
MILLIONS
TIMELINE
Patient Visits Unique Patients

8. CMS Penalties Avoided by IRIS
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Year Physicians MFS PQRS
Penalty
VBM
Penalty
MU
Penalty
Total
2014 4,130 $338,000 $27.9M $27.9M $55.8M
2015 10,800 $338,000 $73.0M $73M – $146M $109.5M $255.5M-$328.5M
2016 12,000 $338,000 $81.1M $81M – $162M $121.7M $283.9M-$365M
2017 12,000 $338,000 $81.1M $81M – $162M $121.7M $283.9M-$365M
2018 12,000 $338,000 $81.1M $81M – $162M $162.2M $283.9-$405.6M

9. IRIS Impact: New Knowledge to Measure “Value”
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• Natural history data
• Prevalence data
• Treatment impacts
• Drug interactions
• Complications
• Rare diseases

10. Big Numbers 2013-June 2016
• Cataract surgery
• 3,738,937 eyes
• 2,356,159 unique patients
• Primary open-angle glaucoma
• 3,251,938 unique patients
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11. Big Numbers 2013-June 2016
• AMD diagnosis
• 2,230,755 unique patients
• Anti-VEGF injections
• 4,468,969 injections
• 577,048 unique patients
• Diabetic retinopathy
• 1,220,770 unique patients
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12. • Rebranding—AAO and the profession
• Communicating externally
• Engaging the patient
• Demonstrating value
• Thinking about populations of patients
P2P: Patients to Populations:
Repositioning the Profession

14. EyeSmart Audience Growth
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0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
Q12011
Q22011
Q32011
Q42011
Q12012
Q22012
Q32012
Q42012
Q12013
Q22013
Q32013
Q42013
Q12014
Q22014
Q32014
Q42014
Q12015
Q22015
Q32015
Q42015
Q12016
Q22016
Q32016
Visitors
• Data represents monthly totals combined for each quarter
• Q3 2016 is projected

15. August: Callie’s story
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16. NASEM Study:
Reprioritizing Eye Health
• Examine the core principles and public health strategies
to reduce visual impairment and promote eye health in
the United States.
• Action plan for public and private collaborations at the
community, state, and national levels to elevate vision
and eye health as a public health issue.
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