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Medicare News
Senior Citizens with Vision Loss Cost Medicare
Billions, Say Ophthalmologists
Eye docs want more emphasis on preventive care by
Medicare, insurance plans
 February 1, 2007 - Senior citizens with vision
problems are costing Medicare more than $2 billion per year in "non-eye
related maladies and healthcare needs," says a study in the journal
Ophthalmology. The American Academy of Ophthalmology, that publishes the
magazine only for its members, responded with a call for Medicare and
insurance plans to put stronger emphasis on preventive eye care.
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“We have always understood the devastating personal
impact of blinding eye disease on patients and their families,” said
Jonathan C. Javitt, MD, MPH, lead researcher on the study conducted by
researchers affiliated with the Potomac Institute for Policy Studies,
the Wilmer Eye Institute at Johns Hopkins University and Pfizer, Inc.
“With this study, we are seeing the serious economic impact of poor
vision health on the health care system and those who pay for it.”
The study – which looked at a 5 percent sampling
(approximately 1.5 million people) of Medicare beneficiaries
continuously enrolled from 1999 to 2003 – concluded that those with
moderate, severe and total vision loss experienced increases in
depression, injuries and the need for nursing home facilities.
Titled “Association between Vision Loss and Higher
Medical Care Costs in Medicare Beneficiaries,” the study showed Medicare
beneficiaries with coded diagnoses of vision loss incurred significantly
higher costs than those with normal vision, and approximately 90 percent
of those costs were non-eye related.
“With the soaring costs of health care, this study
is an important reminder that preventing vision loss saves both sight
and money,” said H. Dunbar Hoskins, MD, executive vice president for the
American Academy of Ophthalmology.
Extrapolating to the entire Medicare population,
blindness and vision loss are associated with $2.14 billion in 2003
non-eye related medical costs, Dr. Javitt said. He said those with
moderate loss, severe loss and blindness had annual non-eye related
costs of $2,193, $3,301 and $4,443, compared to the costs of those with
normal vision.
According to the study, $460 million was associated
with those with existing vision loss and $1.68 billion was associated
with those who developed vision loss during the study period. For those
with newly developed vision loss, the adjustment to the new eye disorder
may have contributed to the increased costs for depression, injuries and
the need for skilled nursing home assistance.
More than half of the cases were due to age-related
macular degeneration (AMD) and glaucoma. A sizable number of cases of
vision loss were due to cataracts that had not been surgically removed.
“These are all treatable conditions. If identified
early, the adverse effects of glaucoma and AMD can be minimized, and
cataracts can easily be treated,” Dr. Hoskins said. “With the results of
this study, it is clear that taking care of your eyesight is not only in
the best interest of patient health, but it also is a benefit to the
country’s Medicare system.”
The Academy and Dr. Javitt said the study is a
chance for the Centers for Medicare and Medicaid Services (CMS) to build
on its landmark Medicare Glaucoma Detection Act of 2001, which covers an
annual glaucoma screening for patients at risk, as well as its coverage
of eye exams for diabetics, which has been available since 1998.
However, awareness of these benefits is low. For example, less than 45
percent of Medicare diabetics have had an eye exam.
“Medicare has already taken an important first step
in making screenings available for those who are most at risk,” Dr.
Javitt said. “CMS’ ‘welcome to Medicare’ physical examination should
make vision assessment a key component of these visits with primary care
physicians. If problems are found, physicians can refer those with
problems to ophthalmologists for further care.”
Editor's Notes:
Ophthalmology Journal
Ophthalmology, the official journal of the American Academy of
Ophthalmology, publishes original, peer-reviewed reports of research in
ophthalmology, including basic science investigations and clinical
studies. Topics include new diagnostic and surgical techniques,
treatment methods, instrument updates, the latest drug findings, results
of clinical trials, and research findings. Ophthalmology also
publishes major reviews of specific topics by acknowledged authorities.
1 Ophthalmology, Volume 114, Number 2,
February 2007, pgs. 238-245.
About the American Academy of Ophthalmology
American Academy of Ophthalmology is the world's largest association of
eye physicians and surgeons—Eye M.D.s—with more than 27,000 members
worldwide. Eye health care is provided by the three “O’s” – opticians,
optometrists and ophthalmologists. It is the ophthalmologist, or Eye
M.D., who can treat it all: eye diseases and injuries, and perform eye
surgery. To find an Eye M.D. in your area, visit the Academy's Web site
at http://www.aao.org.
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