Power Hour Optometry
Episode: Managing Managed Care, Capture Rates and the Missing Middle for Practice Growth with Todd Lassone
Host: Eugene Shatsman (The Power Practice)
Guest: Todd Lassone (Senior Manager, Strategic Partners, EssilorLuxottica)
Release Date: October 9, 2025

Overview

This episode explores how optometric practices can maximize profitability and improve patient care by taking a fresh look at managed vision care plans. Guest Todd Lassone, with 33 years of experience both in-practice and industry-side, shares tactical strategies on capture rate improvement, tapping into the “missing middle” of patients, and deploying smart inventory and communication tactics to drive sustainable practice growth. The conversation debunks some industry myths, champions actionable patient segmentation, and highlights how emotional connections and practical offerings can transform the economics of managed care.

Key Discussion Points and Insights

1. The Three Patient Buckets and Untapped Profitability

• Patient Segmentation: Todd stresses categorizing all patients into three groups for actionable insights:
  • New patients – Practice has no history/data ([00:00])
  • Existing captured – Regulars who purchase each year (profit drivers)
  • Existing uncaptured – Largest group of untapped profitability; patients who come for exams but buy eyewear elsewhere

“If the existing uncaptured patients are our largest group of untapped profitability, why are we not targeting them? Why are we not absolutely going out and trying to get those patients back into our system?”
— Todd Lassone [00:00]

2. Understanding Managed Care as Opportunity Not Adversity

• Vision benefit plans (VSP, EyeMed, etc.) often viewed adversarially, but Todd argues these are patient pipelines.
• Practices often focus on reimbursement frustrations but overlook the scalable opportunities within their current patient base.

“...managed care plans, they're just pipelines of patients... If we have this pipeline of patients that are coming through, we want to make sure that A, we're serving them great, ...and B, that we're being able to close the circle of care...”
— Todd [06:27]

• Industry tension: Optometrists and insurers both vie for patient loyalty, creating constructive friction and prompting regulatory tweaks.

“...in the final analysis though, they both need each other.”
— Todd [09:00]

3. The Importance of Capture Rate & Shifting Practice Economics

• Detrimental effects of low capture rates:
  • Practices with a 50–60% capture rate see revenue/profit from dispensing (materials) invert, relying too much on exam/professional fees ([13:05]).
• Simple math shows the missed revenue when half the day’s patients walk and take benefits elsewhere.

“...how much more money would you have on your bottom line if you continue to grow your professional fees? But yet your capture rate was in the 70s... hundreds of thousands of dollars more money.”
— Todd [13:05]

4. The “Missing Middle” – Value-Based Shoppers

• 40–49% of U.S. consumers are value-centric, spanning generations (Boomers, Gen X, Millennials, Gen Z), not just young shoppers ([28:28]).
• The “missing middle” includes patients who once bought premium but experience lifestyle or economic shifts.
• Often, these patients are not presented affordable, branded, quality options—driving them to outside retailers.

“A lot of times it’s the progressive lens wears. It’s our most profitable patients that are walking out.”
— Todd [29:00]

5. Concrete Strategies to Recapture Lost Patients

Patient Segmentation in Action

• Use colored folders for easy team identification:
  • Yellow folder: Existing, uncaptured patients — triggers customized interaction throughout their visit ([36:35]).
  • Entire team aware; shift communication and solution focus.

Leverage Non-Selling Staff

• Pretesters (compared to hairdressers—patients “tell them everything”) can gently uncover why patients don’t purchase and relay to the doctor ([36:21]).

Soft Conversation Starters

• Examples for pretesters:
  • “I can’t find this pair of glasses in our records—where did you get them?”
  • “Do these glasses loosen up often? Have they always been this way?”
• Note answers, and use in the doctor’s consult ([36:35]).

Personalize Doctor Engagement

• The doctor can directly, empathetically address affordability, offer mid-range options, and reset expectations for the patient.

  • “You know we’ve got a ton of other stuff, right?” ([40:00])

• Highly personalized, lifestyle-informed solutions cement value and loyalty ([41:01]).

Inventory & Frame Board Strategy

• Add attractive, brand-recognized frames at $160–$220 price points. Avoid “just generic,” ultra-low-cost frames that lack emotional or brand appeal ([33:15]).
• Branded value frames resonate emotionally and prevent patients from perceiving the optical as “too expensive” ([33:15], [49:59]).
• “Static board” (keeping bestsellers constantly stocked) increases profitability ([56:41]).

6. Addressing Cannibalization Fears

• Adding affordable options doesn’t materially cannibalize high-end sales.
• Segmentation ensures premium-oriented patients continue to receive premium recommendations.
• Value-driven patients, once offered attainable, quality solutions, are recaptured without overwhelming discounting ([44:45], [47:03]).

“These are the people that need a different solution to bring them back. And quite frankly, when we can bring forward those customized solutions for them, we can meet them where they are. ...We don’t have to change what we’re doing except for those people. Everything else is business as usual.”
— Todd [46:42]

7. The Emotional Component in Eyewear Decisions

• Frames are the emotional connectors; patients justify paying more for a frame that excites them ([49:59]).
• Practices with the best frame boards see capture rates over 100%, as patients from other practices come to buy their glasses ([50:30]).

“Frames do matter. Is that that emotional component? They're like, oh, I like the way I look with this one.”
— Todd [50:30]

8. Practical Metrics and “The Frame Game” (VSP Reports)

When reviewing practice performance:

Top metrics to monitor ([52:39]):

1. Average revenue per patient ([52:39])
   • Benchmark vs. state average; huge bottom-line impact even at “average”
2. Capture rate
   • Total materials dispensed ÷ patients seen (not just spectacle/contact, but both)
   • Ask: “Who’s walking, and why?”
3. Practice dispensary scorecard (e.g., Page 6, VSP report)
   • See top-heavy vs. well-balanced lens tiers
4. Demographic mix
   • Compare share of 45+ patients to progressive lens sales—are your most profitable demographics disengaging?
5. Average frame revenue
   • Is it below/at/above average?
     If so, reassess inventory for brand appeal and price point diversity.

“The dispensary is the only room in the office that’s literally wallpapered with fifteen hundred dollar bills... If that frame ain’t paying rent, you got other problems.”
— Todd [56:41]

Notable Quotes & Memorable Moments

• “Purity is not a virtue in this situation... you can look at it and say, you know what, I am doing a great job of skimming the cream, but there's a whole lot that you're missing out on.”
  — Todd [19:57]

• “No one ever said the doctor spent too much time with me.”
  — Todd [40:00]

• “You should consider your dispensary as the laboratory of commerce in your practice... experiment, right?”
  — Todd [58:28]

• “I want to, I would rather these doctors be much more slow and steady through this. Bring these people back in and really benefit... no downside to having a balanced portfolio that serves the grand majority of your practice.”
  — Todd [59:35]

Timestamped Highlights

• [00:00] Todd’s “three patient buckets”—why recapturing existing uncaptured patients is the hidden profit engine.
• [06:27–09:00] Discussion on managed care as a patient pipeline—opportunity, not just adversity.
• [13:05–14:47] Discussion around the economic impact of low capture rates.
• [28:00–33:08] Defining and understanding the “missing middle” in optical retail.
• [33:08–36:18] Implementation: Real-world example of using inventory adjustments and patient segmentation to drive capture rate from 50% to success.
• [36:35–41:00] Tactical playbook: Pretesters, colored folder system, and patient-centric dialogues to win back lost patients.
• [44:45–47:49] Segmentation as the solution to the “cannibalization” fear.
• [49:59–50:30] Frames’ emotional power and practices achieving >100% capture rates.
• [52:39–56:41] “Frame game” and critical VSP report metrics.
• [58:28–60:13] Todd’s parting wisdom: Use your dispensary as a laboratory, market smarter to serve existing yet disengaged patients.

Conclusion

Todd Lassone provides a fresh and actionable model for managed care success by mining the potential within existing patient relationships. By segmenting visitors, empowering staff with empathetic scripts, adjusting inventory to truly suit local demand, and understanding the emotional and financial levers at play, practices can transform managed care from a frustration into a growth engine—no extra patient volume required.

“Mine the intrinsic wealth that is currently in your practice. ... Engage with those patients ... Because that is where we will see the practitioners at their absolute most successful.”
— Todd [58:28–59:35]