眼科医生和视光师联合管理白内障手术。
Joint Management of Cataract Surgery by Ophthalmologists and Optometrists.
机构信息
Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.
Department of Health Science Research, Mayo Clinic, Rochester, Minnesota.
出版信息
Ophthalmology. 2016 Mar;123(3):505-13. doi: 10.1016/j.ophtha.2015.10.037. Epub 2015 Dec 8.
PURPOSE
To estimate the rate and geographic variation of cataract surgery that is managed jointly by ophthalmologists and optometrists in aging Americans.
DESIGN
Database study.
PARTICIPANTS
United States fee-for-service (FFS) Medicare Part B beneficiaries and their providers.
METHODS
Medicare Provider Utilization and Payment Data furnished by the Centers for Medicare and Medicaid were used to identify cataract surgery claims among FFS Medicare Part B beneficiaries in all 50 states and the District of Columbia in 2012 and 2013. Payments and joint management rates of cataract surgery by ophthalmologists and optometrists were calculated for each United States state. Geographic variations were evaluated by using the extremal quotient and coefficient of variation (CV).
MAIN OUTCOME MEASURES
Medicare allowed payments for cataract surgery (Current Procedural Terminology codes 66982 and 66984) and number of unique FFS Medicare Part B beneficiaries undergoing cataract surgery.
RESULTS
The overall national rate of joint management of cataract surgery by ophthalmologists and optometrists among FFS Medicare Part B beneficiaries was 10.9% (range by state, 0%-75%) in 2012 and 11.1% (range by state, 0%-63%) in 2013. In 2013, the mean extremal quotient was 67 and the CV was 82.2, demonstrating very high variation in joint management between states. The Medicare allowed payment to optometrists in the joint management of cataract surgery was 2.1% of the total Medicare allowed payments for cataract surgery codes in 2012 and 2013. Twenty percent and 24% of all Medicare-participating optometrists submitted 10 or more Medicare claims in the joint management of cataract surgery in 2012 and 2013, respectively.
CONCLUSIONS
The overall rate of joint management of cataract surgery by ophthalmologists and optometrists among Medicare beneficiaries was 10.9% in 2012 and 11.1% in 2013. Very high geographic variation was documented, with joint management rates ranging from 0% to 63% across states in 2013.
目的
评估美国老年人群中眼科医生和验光师联合管理白内障手术的比率和地域差异。
设计
数据库研究。
参与者
美国按服务项目付费（FFS）医疗保险 B 部分的受益人和他们的提供者。
方法
使用医疗保险和医疗补助服务中心提供的医疗保险 B 部分按服务项目付费受益人的医疗保险提供者使用和支付数据，确定 2012 年和 2013 年全美 50 个州和哥伦比亚特区的 FFS 医疗保险 B 部分受益人的白内障手术索赔。计算了每个州眼科医生和验光师联合管理白内障手术的支付额和联合管理率。通过极值商和变异系数（CV）评估地域差异。
主要观察指标
医疗保险支付的白内障手术费用（当前程序术语代码 66982 和 66984）和接受白内障手术的 FFS 医疗保险 B 部分受益人的独特人数。
结果
2012 年，FFS 医疗保险 B 部分受益人中眼科医生和验光师联合管理白内障手术的全国总比率为 10.9%（州间范围：0%-75%），2013 年为 11.1%（州间范围：0%-63%）。2013 年，极值商的平均值为 67，变异系数为 82.2，表明各州之间的联合管理差异很大。2012 年和 2013 年，医疗保险向联合管理白内障手术的验光师支付的款项分别占白内障手术总医疗保险支付额的 2.1%。2012 年和 2013 年，分别有 20%和 24%的参与医疗保险的验光师在联合管理白内障手术中提交了 10 份或更多的医疗保险索赔。
结论
2012 年和 2013 年，医疗保险受益人中眼科医生和验光师联合管理白内障手术的总比率分别为 10.9%和 11.1%。记录到了非常高的地域差异，2013 年各州的联合管理率从 0%到 63%不等。
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