Eye Physicians and Surgeons Warn Reduced Medicare Payments Could Increase Health Risks for Seniors
SAN FRANCISCO and WASHINGTON—As the country begins to feel the effects of the sequester, nearly 400 ophthalmologists representing the American Academy of Ophthalmology are meeting on Capitol Hill this week to urge policymakers to halt Medicare cuts which could endanger seniors' eye health.
While the incidence of eye diseases such as age-related macular degeneration, glaucoma, cataract and diabetic retinopathy continues to grow among older Americans, stable Medicare funding to prevent and treat these conditions is essential to stop debilitating vision loss. In fact, research indicates that better prevention and management of eye conditions could help reduce future health care spending. Key evidence from recent studies includes:
- A major study of Medicare beneficiaries showed that cataract surgery can significantly reduce the risk of hip fractures compared with those who did not undergo the procedure. This suggests that cataract surgery is an effective intervention to prevent fractures and reduce related costs.
- Patients' risk of vision loss due to diabetic retinopathy can be significantly reduced with proper screening and treatment of the eye disease, according to a 20-year population-based study on causes of age-related eye diseases. Future access to such care will be crucial, as the growing epidemic of type 2 diabetes impacts more Americans over longer lifespans.
- A landmark national study published in Ophthalmology journal found that glaucoma care is cost effective, both in terms of preserving vision and increasing quality-adjusted life years.
Conversely, cuts in Medicare payments to physicians could be detrimental to ophthalmic care for seniors. A recent survey of Academy members indicated that 42.8 percent of ophthalmologists would be forced to close their medical practices to new Medicare beneficiaries or restrict the number of new program participants they see, while 28.3 percent predicted they would have to limit access of their current Medicare patients to urgent-care treatment only.
Because most eye diseases are age-related, ophthalmologists— medical doctors who specialize in the diagnosis, medical and surgical treatment of eye diseases and conditions— have disproportionately more Medicare patients compared to other medical specialties. Nearly 50 percent report that Medicare beneficiaries make up more than 60 percent of their practice.
"Tens of millions of older Americans depend on Medicare to provide timely access to sight-preserving medical care. Without these services, seniors will be put at increased risk of vision loss and blindness," said David W. Parke II, M.D., CEO of the American Academy of Ophthalmology. "Congress must take steps to prevent this by ensuring that doctors have the appropriate government support to deliver these vital services to our patients. Such action will aid our country's health care as well as its economy."
Michael X. Repka, M.D., medical director for governmental affairs for the American Academy of Ophthalmology, added: "Congress should permanently repeal the outdated sustainable growth rate formula that is used to calculate updates in Medicare physician reimbursement. This faulty formula should be replaced with fair payment models which are currently being developed to improve quality of care and lower costs."
This week's activities were organized by the Academy as part of its larger advocacy program. This year, in addition to the call for stable funding and reimbursement for Medicare, the Academy's advocacy agenda emphasizes:
- Relieving burdens in the adoption of electronic health record technology. The Electronic Health Records Improvements Act (H.R. 1331) would provide exemptions for small practices and physicians nearing retirement to avoid workforce shortages.
- Clarifying the role of health care providers. Congress should pass truth-in-advertising legislation that would alleviate the public's confusion over who is providing their health care by requiring providers to disclose their education and training.
- Promoting vision-research funding. Congress must ensure adequate funding for vision research, including $730 million for the National Eye Institute and $10 million for the Department of Defense Peer Reviewed Vision Trauma Research Program.
About the American Academy of Ophthalmology
The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons — Eye M.D.s— with more than 32,000 members worldwide. Eye health care is provided by the three "O's" – ophthalmologists, optometrists, and opticians. It is the ophthalmologist, or Eye M.D., who has the education and training to treat it all: eye diseases, infections and injuries, and perform eye surgery. For more information, visit www.aao.org The Academy's EyeSmart® program educates the public about the importance of eye health and empowers them to preserve healthy vision. EyeSmart provides the most trusted and medically accurate information about eye diseases, conditions and injuries. OjosSanos™ is the Spanish-language version of the program. Visit www.geteyesmart.org or www.ojossanos.org to learn more.
 Risk of hip fracture following cataract surgery in Medicare beneficiaries. JAMA 308: 493-501
 Incidence of visual impairment over a 20-year period. Ophthalmology http://www.aaojournal.org/article/S0161-6420(12)01161-X/abstract
 The cost-effectiveness of routine office-based identification and subsequent Medical treatment of primary open-angle glaucoma in the United States. Ophthalmology 116: 823-832