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Utah Optometrists vs. IHC HMO

on February 14th, 2005 | Filed under Optoblog

In Utah, the Daily Herald reports that Judge Bruce Jenkins decided Intermountain Health Care is not in violation of anti-trust laws. For those of you outside Utah, IHC is the major HMO in Utah. Almost everyone is a member of IHC. My understanding of the issue is that IHC allegedly favors ophthalmology over optometry.
I agree with the plaintiffs. IHC is patently biased against optometry. Do a search on the IHC web site for optometrist providers, and you will see there are only 32 optometrists paneled with IHC in the entire state of Utah while ophthalmology has 87 providers. This ratio is out of proportion to the number of Utah eye care practitioners (157 optometrists registered with American Optometric Association and 111 “EyeMDs” registered with American Academy of Ophthalmolgy.) Also, note that only 2 optometrists are in the SLC valley, none in Provo, none in Cache Valley, and none in Ogden. The rest are all located outside of the Wasatch front which is the main population area in the state. Tell me how that happens unless someone has a vendetta against optometry.
Supposedly, if the optometrists would have won, they were going to finagle a way so that only the 49 optometrists paying money for the suit get the benefits of getting on board with IHC (I heard this with my own ears from one of the plaintiffs). I don’t see how that would happen. The law is the law, and I would think everyone could reap the benefits if IHC were found guilty. I believe they were hoping that IHC would just settle instead of go to court and that a condition in the settlement would be that only the 49 plaintiffs would get paneled to IHC as optometry providers. So much for that game plan now that Judge Jenkins has ruled.
Even though the lawsuit has failed (but still can be appealed) IHC should allow any Utah optometrist to participate as a preferred provider. IHC should recognize that optometry is the primary eye care profession. You would also think that an HMO would recognize that optometrists on average bill much less that ophthalmologists. (Of course, I guess that doesn’t matter if you are a preferred provider which accepts the allowables.)


3 Responses to “Utah Optometrists vs. IHC HMO”

  1. Chuck U. Farley says:

    IHC needs surgeons. Optometrists do not go to medical, and thus are not surgeons. Doesn’t this make sense to you?

  2. Chuck U. Farley says:

    IHC needs surgeons. Optometrists do not go to medical school and are not surgeons. It seems obvious why they hire eye surgeons to do their surgery.

  3. What doesn’t make sense is that you’re missing the whole issue. IHC has plenty of eye surgeons, the point is they don’t have enough optometrists, especially in the Valleys. Optometrists manage medical diagnoses all the time (uveitis, conjunctivitis, glaucoma, etc.) IHC panels optometrists outside the main population corridor in the state, but in the Salt Lake, Ogden, Provo, and Cache Valley areas they do not because they favor ophthalmology (read in: discriminate against optometry).
    The issue is not about needing eye surgeons. IHC patients need eye CARE. Yes, if the condition requires surgical management, then it goes to an ophthalmologist. For the patient, the more options the better. An optometrist and an ophthalmologist can treat non-surgical eye conditions, so why wouldn’t the patient want the option to go to the closest one to their house or to the ECP that they know and like?