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American Academy of Ophthalmology Issues Statement on Release of Medicare Physician Pay Data

04/09/2014   06:30:00 PM

Ophthalmologists urge care in interpreting Medicare Part B information 

SAN FRANCISCO — Ophthalmologists are urging caution in the use of Medicare physician payment data released by the Centers for Medicare and Medicaid Services today. The American Academy of Ophthalmology, the world's largest association of eye physicians and surgeons, joins the medical community in raising concerns that steps should be taken to avoid misinterpretation and errors.

"Ophthalmologists support sharing data to advance improved patient outcomes and care, but drawing conclusions from this data is anything but transparent or easy," said David W. Parke II, M.D., CEO of the American Academy of Ophthalmology. "Claims and payment data alone are not adequate proxies for medical necessity of care or outcomes of care."

Ophthalmology has one of the highest practice overhead costs of any medical specialty, including staff, technology and equipment. For many practices, a significant portion of Medicare reimbursement goes to cover these costs, but the payment data released reflect only the gross payments and do not account for those expenses. In addition, the data include Medicare payments made to ophthalmologists for costly drugs used to treat eye diseases that are then passed through to drug manufacturers and suppliers.

"Including those drug reimbursement dollars as part of a physician's Medicare payment artificially inflates the amount paid to ophthalmologists," said Dr. Parke.  

Ophthalmology also represents a significant portion of Medicare Part B payment due to the frequency of age-related eye disease that presents among patients age 65 and older. Some of the most common diseases that cause blindness occur almost exclusively in the Medicare age group and can be expensive to treat. These include cataracts, age-related macular degeneration and glaucoma – all of which may require treatment by ophthalmologists in order to prevent blindness.

About the American Academy of Ophthalmology
The American Academy of Ophthalmology, headquartered in San Francisco, 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.

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