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EW SHOW DAILY 30 ASCRS Symposia Monday, May 8, 2017 by Ellen Stodola EyeWorld Senior Staff Writer Next, he said to get real about financial planning. Fewer than 50% of eye surgeons have a personal financial plan, but you should get one, Mr. Pinto said. Make your practice more enjoyable, so that you can work longer if required, he said, adding that you also have to stop seeing your buy-out as a source of material retirement funding. His fourth suggestion for what practitioners should be doing now was to increase passive income, and he offered a number of ways to do this, including hiring employee optometrists, owning part or all of an ASC, dispensing optical goods, optimizing testing provided by lay staff, and owning your building instead of leasing. Boost personal production, Mr. Pinto said. If you add just three patients to your daily template, this can add $100,000 to your annual pay. His last point was to "cut the fat." The average new client work- up reveals $10 or more per patient visit in wasted expenses, like excess staffing, low provider productivity, ineffectual marketing, and underuti- lized facilities, he said. Richard Lindstrom, MD, Minneapolis, discussed the role of private equity and consolidation in the future of ophthalmic care. What is private equity? Dr. Lindstrom said it is a vehicle for in- vesting primarily in private compa- nies. The investments often involve debt plus equity in order to amplify returns. What are private equity firms? He said that these are firms that raise funds in order to invest in various A symposium titled "Sur- vive or Thrive in the Modern Healthcare Envi- ronment: Clinical Chang- es to Practice," examined a number of topics in ophthalmic practice. John Pinto, San Diego, spoke about "What Should the Private Practice Ophthalmologist Be Doing Today?" He discussed five critical trends. The first was that healthcare service delivery is a classic bubble market. The bubble will pop slowly or quickly in your lifetime, Mr. Pinto said. The second trend was that the "grand consolidation marches on." This is not new, he said. Health sys- tems are rounding out their teams. There are also private equity firms, and practices are acquiring and merging with each other. This is all driven by the bubble, he said. Mr. Pinto noted that, over the next 10 years, investments will fall short of their historical returns by about 35%. The fourth trend was a hypervolumetric-hypoeconomic era, and his final critical trend was that practice succession is harder to achieve because of more demand and fewer doctors. Mr. Pinto then offered six things that wise practitioners are doing now. The first, he said, is to decide if you are going to grow, shrink, join, retire, or do nothing. Talk to local experts, he said. Inventory the options and decide and act, Mr. Pinto said. The second action is to rethink succession planning, he said. Jobs exceed applicants in most markets. Goodwill value is diminishing brisk- ly in secondary markets, Mr. Pinto said. You may need to work longer than expected to be financially inde- pendent, and you may never find a successor, he added. types of companies. Firms will have different investment strategies and often focus on one specific indus- try such as healthcare, he said. The typical investment structure could include pension funds, high net- worth investors, and foundations. A typical private equity fund has a lifespan of around 10 years, Dr. Lindstrom said, and generally, the fund will invest its capital within 3–5 years and then has another 5 years or so to liquidate and sell its holdings. So, what's the interest in the healthcare space? he asked. Health- care costs are growing faster than the GDP, Dr. Lindstrom said. In the early 1990s, healthcare costs were 13% of the GDP, and in 2020, healthcare cost will approach 20% of the GDP, he said. The business rationale for the eyecare sector may include the demographic changes; it's a disparate specialty seen as ripe for consolidation; there is physician supply/demand imbalance; there is increasing complexity of the busi- ness and the availability of multiple profit streams. But what's in it for the physi- cian? Dr. Lindstrom said physicians may have the ability to monetize equity, it assists them with practice management, they could leverage resources to achieve greater scale, it would facilitate succession planning, and it could provide a source of capital for growth. EW Editors' note: Dr. Lindstrom has finan- cial interests with a number of ophthal- mic companies. Mr. Pinto has financial interests with J. Pinto & Associates Inc. Healthcare topics explored in symposium Dr. Lindstrom discusses the role of private equity and consolidation in ophthalmic care. is implemented. There will also be an open discussion period to discuss current hot topics in the health IT industry. Candace Simerson, COE, Min- nesota Eye Consultants, Minneapo- lis, chair of the ASCRS HIT Commit- tee, will moderate the session. The symposium will take place today from 1:00 to 2:30 p.m. in the Convention Center's lobby level, Petree Hall C. EW Attend the HIT symposium to learn what you need to do to succeed H ealth IT is critical to you and your practice's success under MACRA. This year's HIT (health information technology) sympo- sium, sponsored by the ASCRS HIT Committee, will cover components of MACRA that specifically rely on the health IT industry, such as the exchange of health information, the reporting on information to public health organizations and clinical data registries, and protecting pa- tient health information. Allison Madson, ASCRS manag- er of regulatory affairs, will provide an overview of the Advancing Care Information category in MIPS and what it means for your practice. Valerie Salmeri, product manager for MedNetwoRx, Dallas, will offer health IT insights on how to ensure proper IT management through the exchange of health in- formation and reporting of informa- tion as MACRA is implemented. Charles Killmer, security officer for Netgain Technology, Lexington, Kentucky, will join panelists to discuss how to ensure security and proper IT management as MACRA What does MACRA mean for your health IT strategy?

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