The Marketplace of Opportunity TOOLS. action. SHOPPER A study exclusively from P-IOL PLANS DATA. engagement. results LASIK. touchpoint.

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1 % The Marketplace of Opportunity Factors Impacting Refractive Practice Growth resources differentiation results SUPPORT P-IOL SUCCESS LASIK TOOLS DATA marketshare action PLANS touchpoint marketing GROWTH engagement SHOPPER A study exclusively from

2 The CareCredit 2012 Economic Report CareCredit values your opinion. So each year, we conduct a national study with enrolled refractive practices to determine critical shifts in the marketplace. For the 2012 End of Year study, there were 332 total respondents. Their responses indicate: Competitive pricing and discounting continue to be an issue, even while some practices are experiencing growth. Conversion to surgery ratios are still being directly impacted by patient concerns about cost and budget. Patients are very likely to continue to be interested in financing. Offering every patient the CareCredit credit card as a financing option remains a proven way to achieve real results in conversion ratios, procedure volume and other key areas.

3 Patients are Becoming Savvy Shoppers for Refractive Services. More and more patients are treating refractive procedures as a commodity rather than a specialty. With price and budget being high on their list, the trend is for patients to shop for the best overall deal, and that includes whether or not a practice offers financing. GAS TUITION MORTGAGE groceries UTILITIES TAXES EYE CARE new car travel 71% reported an increase in cost or budget becoming a concern for patients. 68% saw an increase in patients price shopping. 67% reported an increase in patients requesting financing. 61%??? saw an increase in new patient inquiries. 45% of respondents saw an increase in patients visiting multiple practices before scheduling a LASIK or P-IOL procedure.

4 A Shift in Procedures Mirrors the Shift in Changing Demographics. The impact of an aging Baby Boomer population is perhaps becoming more evident, with the volume for P-IOLs outpacing the volume for LASIK procedures; however, while the procedure may be changing, the average cost is generally the same. More disconcerting is the fact that nearly a third of respondents are losing sleep over profitability, and nearly a quarter have seen an increase in delinquent accounts or collections. 32% LASIK 31% VOLUME STAYED THE SAME 33% P-IOL VOLUME DECREASED LASIK 8% P-IOL LASIK 28% INCREASED VOLUME P-IOL 44% INCREASED VOLUME 32% Profit keeps them up at night. 35% Business challenges do not keep them up at night. AVG LASIK 33% reported 1-2K/eye 35% reported 2-3K/eye 16% reported >3K 25% reported 1-2K/eye 32% reported 2-3K/eye 20% reported >3K AVG P-IOL COST EXPIRED 24% saw an increase in delinquent accounts or collections.

5 Practices are Moving Beyond Refractive Procedures to Keep More Patients Coming Back. Perhaps as a response to changes in consumer behavior and LASIK/P-IOL volumes, offering diversified services beyond refractive is now commonplace. A majority of respondents report having an optical shop, and almost half are offering minimally invasive cosmetic procedures contributing to return visits from previous patients for additional treatments or procedures. What other procedures have you seen an increase in? (Respondents reporting a 1 10% increase in the following) Dry eye treatment Specialty contact lenses Limbal relaxing incisions Optional screening services Oculoplastic surgery Nutritional supplement or vitamin sales Hearing services 53% 35% 29% 24% 23% 22% 8% Return Visits Return Visits Return Visits 38% reported previous LASIK/P-IOL patients returning for other procedures/treatments. 30% Reported case sizes over % Reported average minimally invasive case size: % increase RETURN VISITS 48% offer minimally invasive cosmetic procedures like BOTOX.

6 Providing an Easy Way to Pay Impacts Both Patients and Practices for the Better. With financing being a critical component of what the shopping patient is looking for, a common theme among practices is to emphasize the importance of using and the willingness to offer financing for both vision surgery and additional procedures, optical products and services. Over half of practices have experienced a 5 25% increase in procedure volume because they offer financing. 80% of those who have an optical shop reported that they offer CareCredit for optical purchases. 53% report a The majority of practices reported over 36% of their patients pay for their surgical procedures with a consumer credit card. 5 25% of offering third-party financing. increase in procedure volume as a result

7 At Every Touch Point, CareCredit Gives Practices Distinct and Powerful Competitive Advantages. The benefits of CareCredit are readily apparent given the high number of respondents reporting that CareCredit helps them increase their show rate for consultations and the number of scheduled procedures, as well as helps their patients select the ideal procedure or treatment even if it costs more. They also agree that CareCredit provides the support they want/need, is easy to use and helps their patients not only budget for their procedure, but also return sooner for additional procedures or treatments. 71% agree that CareCredit helps them select the ideal procedure/treatment even if it costs more. 89% agree that CareCredit is easy to use. 87% agree that CareCredit helps patients budget for their procedure. 80% agree that CareCredit helps increase show rates for consultations. 58% agree that CareCredit helps them increase the number of scheduled procedures. 58% agree that offering helps them attract new patients when they use it as an offer in their marketing. agree that CareCredit offers great Practice Management support by making access to dedicated team members and call 58% centers easy. 97% of respondents currently offer CareCredit as their patient financing company.

8 2013 CareCredit CareCredit.com option 1, then 6