Upfront: Lab Watch


They'll Manage

They’ll Manage
How managed vision care companies process lenses 


To paraphrase a well-known literary quote regarding flora and fauna, “A lab is a lab is a lab is a lab.”

At least that’s what 20/20 found out when it looked into the lens processing services offered by major managed vision care companies. Many dispensers have bristled at managed care restrictions ever since the insurance model entered the industry full force more than a decade ago. A common complaint has been that some plans mandate the use of specific laboratories—and often plan-owned laboratories—for processing insured patients’ orders.

But, some “managed care labs” are at the forefront of lens processing and order delivery technology and most participate fully with their independent wholesale compatriots in the lab community through organizations such as the Optical Laboratories Association.

To give readers a closer look at the facilities processing managed care work, 20/20 decided to check out the lens processing policies and procedures at four of the largest managed care plans providing vision benefits to patients today:

Spectera/United Healthcare—Baltimore-based vision-care plan
providing benefits to roughly six million patients nationwide
During his days as an optical lab design/efficiency engineering consultant, Richard Mectau was known for advocating the use of conveyor belts to speed up the movement of job trays from station to station, department to department within the lab. It’s a technique he hopes to incorporate in the near future as senior vice president at Crown Optical, the lab facility for Spectera, a position he’s held for the past three years.

“Like any lab, we’re always looking for design aspects that improve efficiency,” he says.

Opened in the mid-1960s—just three years after Spectera itself was established—Crown moved to a new, larger location two years ago to accommodate its growing business. It now processes roughly 1,200 jobs per day, including approximately 150 A-R coated lens pairs with its newly installed Zeiss coating system. The lab has run on computerized blockers, generators and cylinder machines from Loh for years, but it has also incorporated four robotics-adaptable generators from Schneider as part of a Mectau-style re-engineering this summer. The lab’s finishing department runs on 20 National Optronics edgers and uses the CNC drill from Salem for its rimless work.

“We’re also looking to add edgers with robotic capabilities,” notes Mectau. Over the past two years, Spectera has invested more than $3 million in Crown’s facility and infrastructure, according to Sue Cox, vice president of marketing.
Spectera providers are required to send all of their Spectera orders to Crown and they have the option of filing orders by phone, fax or Internet/email. According to Mectau, Crown can deliver typical jobs (surfaced, finished, hard coated and tinted, if applicable) in two days, with an additional day for A-R work. The lab is a Varilux distributor and offers lenses from all major manufacturers, including Zeiss, Hoya and Sola. It also has its own frame line and can order frames from most major manufacturers as well.

“We operate like a lot of independent labs,” says Mectau. “The only difference is that we require the insurance paperwork.”
In fact, adds Spectera CEO David Hall, it was Mectau’s experience working with independent labs across the country that made him attractive to Spectera as it sought someone to oversee the re-working of Crown three years ago. Operating the lab as if it were an independent lab makes the process “seamless” for providers, Hall says, and it has become an important part of the company’s philosophy.

“We consider Crown to be one of the stars of the company,” says Hall. “We’re continually investing in the lab and we have full control of what’s going out to our patients in terms of quality and delivery time. We feel our providers are working with a first-class lab.”

Davis Vision—Plainview, N.Y.-based vision-care plan providing benefits to roughly 19 million patients nationwide
DaFor a managed care company, Davis Vision has a longer lens processing history than some wholesale laboratories. Founded in 1917 as a family optical business on Long Island, N.Y., Davis Vision opened an ophthalmic laboratory in 1964. Later that same year, the company began to offer managed care programs.
Today, the company’s lab division processes all of the Davis patient eyewear orders taken by its providers nationwide. The company now operates five labs spread across the country, including a 15,000-square-foot facility in Philadelphia; a 5,000-square-foot facility in Memphis; a 6,000-square-foot facility in Las Vegas; a 10,000-square-foot facility in Syracuse (which services the company’s Empire Vision retail stores in upstate New York, primarily); and the main, 18,000-square-foot location in Plainview. Together, the labs process more than 6,000 jobs per day.

Davis outfits its labs with state-of-the-art technology and vice president of manufacturing Michael O’Connor says the production facilities undergo “constant evolution and reevaluation.” The company’s Plainview home base, for instance, has employed robotic processing since 1994 and both it and the Philadelphia lab now use robotic generators from Loh. All the labs process lenses with surfacing and finishing equipment from Loh, Gerber Coburn and National Optronics.
Davis labs offer less than two-day turnaround on most orders, though A-R services are currently outsourced. The labs inventory most lens brands and a select number of frame lines. They will also process any patient- and/or provider-supplied frame.

The company constantly monitors its labs for quality. Independent auditors visit each facility weekly and randomly check outbound work for Rx accuracy, etc. Recently, the Davis labs received the Gold-level quality award from ophthalmic product testing laboratory COLTS. In the future, COLTS will be subjecting all new frames Davis introduces to eight different ANSI tests for quality, assuring long-term wearability.

“Our upcoming product launch of 11 new styles will be the first to comply with this process,” explains O’Connor. “Our current top-selling frames have also been certified.”

Davis providers have been able to file orders via the Internet—in addition to traditional methods—since 2000. But, the company has recently initiated a review of its provider web site with the idea of further streamlining the order process, enhancing real-time job tracking capabilities and offering “one-click” access to UPS shipment tracking.

“We deem our laboratories and the services they offer as critical to our overall business,” notes Carl Moroff, OD, executive vice president and chief operating officer at Davis. “They allow us to control the quality of the end-product, which our members are, of course, most concerned about. Also, we feel we have to be in a position to monitor and control costs for our clients. Our labs help us do that.”
Vision Service Plan (VSP)— Sacramento-based vision-care plan started by a group of optometrists in 1955; provides benefits to roughly 27 million patients nationwide

VSP’s approach to lens processing could be called “a tale of two philosophies.” The organization allows providers to use any of the labs in its network of more than 300 independents in addition to its own facility, located near its headquarters.
VSP’s lab network, which was launched in 1972, is made up of independently owned (non-retail operated) labs across the country. The labs maintain their own selection of products and services in addition to the ones covered by VSP. They can also accept orders via traditional paper and phone methods or through VSP’s Eyefinity electronic ordering program.

“VSP has a history of supporting independents overall,” explains Bill Conner, VSP senior vice president, ophthalmic services. “The network is a model we’ve had in place for 30 years and it’s a model we’d like to see continue.”

And work in conjunction with its own lab facility, also established in 1972. Though it offers no incentives to providers to use the Sacramento lab, VSP does employ a small sales force, which, says Conner, promotes the business “like any other lab.”
Today, VSP’s lab is housed in a 27,000-square-foot facility and processes more than 2,200 jobs per day, using generators, cylinder machines and finers/polishers from Loh and edgers from Weco. It also has its own on-site A-R coating lab outfitted for Zeiss Foundation, Sola UTMC and its own house brand (called Acuity Plus).

“Our lab uses state-of-the-art equipment, but we’re not highly mechanized yet in terms of robotics,” notes Conner.
The organization plans to change that with the opening of a new facility at an as-yet-undetermined location in the Midwest, a move Conner says, “will give us a coast-to-coast lab presence.” The new lab will also be a testing ground for new lens processing technologies because, Conner continues, “it’s easier to introduce mechanized equipment when you’re starting with a clean slate.
“Our primary philosophy is that VSP needs to have a presence on the lab side to help us better understand the lab business and the vision business overall,” he adds. “It’s in our best interests to be able to produce our own work. We’re very pleased with our lab network, but the lab industry has changed significantly in the past several years and we’re not sure where it’s going to go. Right now, we have good relationships with our contract labs. They have competitors in the industry, but they work well with each other in groups such as the OLA. We see our lab as coexisting with them in the same way.”

EyeMed—Cincinnati-based vision-care plan owned and operated by the Luxottica Group and LensCrafters
EyeMed is unique among managed vision care plans in that it is a subsidiary of the Luxottica Group, a frame manufacturer that also owns LensCrafters, an eyewear retail chain with more than 800 locations in the U.S. That said, its lens processing philosophy is all about freedom of choice, according to Linda Denham, senior director of provider relations. Of course, its 800 LensCrafters locations, most of which provide for EyeMed patients, process most of their own eyewear orders, sending a small amount of specialty work to the company’s centralized lab at its Cincinnati headquarters. The nearly 18,000 “private” EyeMed providers—including independent opticians, optometrists and ophthalmologists—however, “control their lab choice,” says Denham. “They can send the work to an outside lab they’re comfortable with, or they can use their own on-site lens processing facilities if they have them.” Indeed, the only “catch,” according to Denham, is the providers, and thusly their labs, must meet EyeMed’s stringent quality assurance standards.

And that is no small thing. To ensure patient and provider satisfaction with its services, EyeMed routinely surveys its member patients and providers about the products and services they’ve received. The company also conducts in-store audits, checking equipment and making sure providers are delivering quality materials. EyeMed investigates all complaints and will recommend changes in any areas it deems necessary, including lens processing.

“But we don’t want to be in the business of recommending or mandating labs,” says Denham. “We’re in the business of making sure patients receive quality vision care.”

And that is the end mission of all labs, no matter how they are managed and operated.