Medicare expenditures decrease for glaucoma surgery as number of procedures increases

July 13, 2009,

The overall number of glaucoma surgical procedures appears to be increasing, but payments by Medicare for the procedures have been decreasing, according to a report in the July issue of Archives of Ophthalmology.

Glaucoma is one of the leading causes of blindness worldwide and currently affects more than 2 million people in the United States, according to background information in the article. "Management and treatment of can be costly, and it has been estimated that glaucoma is the primary reason for ophthalmologist visits in the United States," the authors write. One previous study estimated that annual Medicare payments for glaucoma exceeded $1.2 billion each year between 1991 and 2000. "An important driver of glaucoma treatment costs is surgery." Surgery is typically used to reduce intraocular pressure (pressure within the eye) when medications fail to do so.

Jordana K. Schmier, M.A., of Exponent Inc., Alexandria, Va., and colleagues conducted an analysis of Medicare claims and payments for glaucoma surgery between 1997 and 2006. The most common surgical treatments for glaucoma include laser trabeculoplasty, in which a beam of light changes the drainage angle of the eye to relieve pressure; filtering surgery, in which surgeons use a surgical tool to create a drainage hole; shunt surgery, which involves placement of a small plastic tube with an attached pouch; and cyclodestructive procedures, used to reduce the production of eye fluid in severe cases of glaucoma.

"Overall, there were decreases in both the number of glaucoma surgical procedures and the amount of annual payments from 1997 to 2001 but an increase in the number of procedures in the following years," the authors write.

"Trends in claims and payments vary according to procedure. Average payments for trabeculectomies decreased over time, while annual payments for cyclophotocoagulation [a type of cyclodestructive procedure] and shunt-related procedures have increased."

After an initial decline, the number of trabeculoplasties increased, coinciding with advances in technology and changes in the global period for reimbursement (the amount of time after a surgery during which additional billing is limited; in 2002, this period changed from 90 to 10 days for laser trabeculoplasty).

The analysis examines only direct medical fees paid to physicians, which may be less than half of total glaucoma-related expenditures, the authors note. "Regardless, Medicare payments remain an important component of the cost of glaucoma in the United States and the overall trend toward lower-cost surgical procedures (i.e., fewer trabeculectomies) despite the increased use of newer technologies (i.e., more glaucoma drainage devices) observed in this analysis may have a substantial impact on national glaucoma expenses," they conclude. "Further advances and the application of new technologies may help to moderate the cost of providing glaucoma care to all who require it."

More information: Arch Ophthalmol. 2009;127[7]:900-905.

Source: JAMA and Archives Journals (news : web)

Related Stories

Recommended for you

Best of Last Year—The top Medical Xpress articles of 2017

December 20, 2017
It was a good year for medical research as a team at the German center for Neurodegenerative Diseases, Magdeburg, found that dancing can reverse the signs of aging in the brain. Any exercise helps, the team found, but dancing ...

Pickled in 'cognac', Chopin's heart gives up its secrets

November 26, 2017
The heart of Frederic Chopin, among the world's most cherished musical virtuosos, may finally have given up the cause of his untimely death.

Sugar industry withheld evidence of sucrose's health effects nearly 50 years ago

November 21, 2017
A U.S. sugar industry trade group appears to have pulled the plug on a study that was producing animal evidence linking sucrose to disease nearly 50 years ago, researchers argue in a paper publishing on November 21 in the ...

Female researchers pay more attention to sex and gender in medicine

November 7, 2017
When women participate in a medical research paper, that research is more likely to take into account the differences between the way men and women react to diseases and treatments, according to a new study by Stanford researchers.

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.