Medicare Payments for Glaucoma Procedures Dropping Even Though Number of Procedures Has Been Increasing
July 17, 2009
According to a report in the July issue of the Archives of Ophthalmology, while the overall annual number of glaucoma procedures has been growing, payments by Medicare for glaucoma procedures has been decreasing. The drop in total payments for surgical procedures was attributed to a shift to lower-cost procedures.
The report relied on a retrospective study of Part B Medicare data for 100,000 beneficiaries from 1997 to 2006. Researchers found the most common surgical treatments for glaucoma include laser trabeculoplasty, filtering surgery, tube shunt surgery and cyclodestructive procedures.
Overall, there were decreases noted in both the number of glaucoma surgical procedures and the amount of annual Medicare payments from 1997 to 2001, but there was an increase in the number of procedures in the following years. In particular, after an initial decline, the number of trabeculoplasties increased. However, Medicare payments for trabeculectomies decreased over time, while annual payments for newer procedures, such as cyclophotocoagulation and shunt-related procedures, increased.
Limitations on the studies include that it examined only fees paid directly to physicians, and of course, does not include data on patients between 40 to 64 who are not covered by Medicare.
This study brings up several interesting, thought-provoking points: why is there a trend for more trabeculoplasties? How will this trend impact national glaucoma expenditures? With the changes in health care that are being discussed, these types of questions should be looked at by ophthalmologists so we can participate in the discussion and continue to provide quality care for our patients.
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