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Medicare Payments for Major Eye Disease Declines

Lower cataract surgery payments behind decrease, despite rise in disease prevalence

FRIDAY, Dec. 29 (HealthDay News) -- Although the incidence of major eye diseases increased from 1991 to 2000 in the United States, Medicare payments decreased, mostly due to lower reimbursements for cataract surgery, which declined from $1,092 in 1991 to $536 by 2000. The findings are published in the December issue of the American Journal of Ophthalmology.

Martin Salm, M.A., of the University of Mannheim in Mannheim, Germany, and colleagues analyzed data from the 1994 and 1999 National Long-Term Care Survey and from 1991 to 2000 Medicare claims to estimate per capita Medicare payments for age-related macular degeneration, diabetic retinopathy, cataract and glaucoma. The total combined cost of these four eye diseases was also calculated.

Major eye diseases increased Medicare spending by $4.8 billion (1999 U.S. dollars) from 1991 to 1995 and $4.5 billion from 1996 to 2000. Cataract was the most expensive eye disease and cost Medicare $3.8 billion from 1991 to 1995 and $3 billion from 1996 to 2000. The total yearly Medicare cost for age-related macular degeneration, cataract, glaucoma and diabetic retinopathy from 1996 to 2000 was $6.7 billion, and those costs were $7.4 billion from 1991 to 1995.

"Prevalence of major eye diseases increased over time, but the effect of major eye diseases on Medicare payments decreased, mainly as a result of lower payments for cataract surgery in the later years," the authors conclude.

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