News on Wellness

Study Reveals That Ophthalmologists Get a Major Part of Medicare Payments

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Ophthalmologists were the biggest recipients of big Medicare money in 2012, compared to other specialists like cardiologists, orthopedic surgeons or cancer doctors.
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Though health professionals and consumers will be poring over the recently released Medicare info for several months or even years, one amazing detail has already come out, illustrating few of the intricacy innate in the details that have been fought over for long on 880,000 healthcare providers throughout the nation.

Ophthalmologists

The 17,000 providers, who are mainly concentrated in Texas, Florida, New York, and California accounted for $5.6 billion (7%) of the reimbursements to physicians and other healthcare providers. In the total amount, also included is $929 million (cataract surgery), $707 million (eye examinations), and $1 billion (costly eye drugs).

In simple words, we can say that out of the hundred doctors who get the largest Medicare payments, 50% of them are eye specialists.

When questioned about this, ophthalmologists state that a major part of the payment they get from Medicare goes to the cost of the medicines they give to patients in their clinics and so most of that money finally goes to the drug companies, according to them. Eye specialists also claim that they mainly treat older patients when compared to the other specialties, and hence their costs are high.

The reasons include medical procedures, few involving very costly medicines, all of which, are repaid by Medicare.

Dr. Michael X. Repka, the government affairs’ medical director at the American Academy of Ophthalmology stated – “You would obviously expect ophthalmology to be heavily represented in a payment system that is for age 65 and up.”

Medicare has to pay 6% over the average price of the drug, which indicates a bigger dollar amount for a costly drug when compared to a cheaper one. On a nationalized scale, the drug choice can make a huge difference to Medicare.

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