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ARTICLE UnitedHealthcare Study: Comprehensive Eye Exams Can Help Identify Some Chronic Conditions, May Lead to Improved Health and Reduced Costs


MINNETONKA, Minn. (Feb. 20, 2014) Comprehensive eye exams can help identify some chronic conditions, helping with early diagnosis so people can obtain appropriate treatment sooner and take steps to better manage their disease, according to a new study by UnitedHealthcare.

"Impact of Eye Exams in Identifying Chronic Conditions" demonstrates how eye care professionals can play a key role in identifying people with various diseases and then working with primary care physicians to deliver holistic, patient-centered care.

The study is based on an extensive analysis of claims data for UnitedHealthcare plan participants with both medical and vision benefits. It concluded that eye care professionals identified nearly 6 percent of the chronic conditions diagnosed among the study population. For certain diseases, including multiple sclerosis and diabetes, eye care professionals identified 15 percent of study participants diagnosed with those chronic conditions. Other common conditions identified by eye care professionals were high cholesterol and hypertension, rheumatoid arthritis, juvenile rheumatoid arthritis, Crohn's disease and Graves disease.

More than 133 million people nationwide, or nearly one out of every two adults, suffer from at least one chronic condition, according to the Centers for Disease Control and Prevention (CDC). Nearly 26 million people have diabetes; 71 million have high LDL cholesterol; and 67 million have hypertension.

The study highlights the importance of including a comprehensive eye exam in a health benefit package, especially because plan participants often visit their eye care providers more often than they do their primary care physicians.

"The eyes are the window into a person's overall health, and eye doctors play a critical role in identifying and managing chronic conditions, and re-engaging them into care," said Linda Chous, O.D., chief eye care officer, UnitedHealthcare Vision. "When eye care professionals share information about diseases with patients and other care providers, it can lead to better information, better decisions and better health outcomes."

The study reviewed UnitedHealthcare plan participants with both medical and vision benefits during 2011 and 2012. First evidence of a specified chronic condition was verified by the absence of claims for the condition in a review of the prior 18 months of claims from when the chronic condition was identified by the eye care professional. Eye care professionals were credited with identification if plan participants with chronic conditions were reported during a comprehensive eye exam or identified by another health care professional within 60 days following the eye exam, which would indicate that likely a referral to address a condition had taken place.

Employers are increasingly recognizing the role eye health plays in overall health, adopting integrated vision and medical benefits programs such as UnitedHealthcare's Bridge2Health®, which support patients and health care professionals with information, decisions and outcomes. For example:

  • Eye care professionals are encouraged to code claims with chronic condition categories. Those diagnoses are automatically referred to disease management programs for follow-ups based on the patient's needs.
  • Eye care professionals are notified of patients with at-risk conditions during the eligibility verification process, with a recommendation to include a dilated fundus exam, which uses eye drops to dilate the pupil to gain a better view of the eye, as part of the comprehensive eye examination.
  • Patients with diabetes, diabetic retinopathy, hypertension, hypertensive retinopathy, vascular disease or high cholesterol receive eye exam reminders via a phone call.
  • For patients who may have chronic conditions, referrals to primary care providers or specialists are supported via specially designed forms available online to eye care professionals.

More than 130 companies representing 6.8 million plan participants have already selected Bridge2Health's integrated approach for vision benefits to help create healthier employees, lower health care costs and increased productivity. With wellness as a core value for many companies, programs such as UnitedHealthcare's Bridge2Health provide employees with the most advanced programs and resources that encourage a healthier workforce.

About UnitedHealthcare

UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. The company offers the full spectrum of health benefit programs for individuals, employers and Medicare and Medicaid beneficiaries, and contracts directly with 800,000 physicians and other health care professionals and 6,000 hospitals and other care facilities nationwide. UnitedHealthcare serves more than 45 million people in health benefits and is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.