- Researchers conducted an economic analysis of simple and complex cataract surgeries using a method called time-driven activity-based costing.
- They reported that although complex surgeries require more time, resources, and effort from the physician compared to simple surgeries, Medicare reimbursements fail to account for these differences.
- This discrepancy may affect doctors financially and could potentially reduce access to care for people needing complex surgeries, thus highlighting the need for more accurate reimbursement rates.
When a person’s vision is impaired as a result of cloudy or opaque areas on the lens of the eye, they may need surgery to remove the lens and replace it with a synthetic one.
This is known as simple cataract surgery.
In some cases, a person may have other eye conditions besides cataracts, which requires additional interventions to be performed during the surgical procedure.
This is called complex cataract surgery.
Complex cataract surgery requires more time, resources, and effort from the physician compared to simple cataract surgery.
However, it remains unclear whether the Medicare reimbursement for complex cataract surgery offsets those increased costs.
Dr. David Portney, a resident at Michigan Medicine’s Kellogg Eye Center, explained to Medical News Today that “there is an incredible lack of understanding of healthcare and medical costs.”
“From my experiences… it has never been easy to accurately point to a cost number for a medical procedure, hospital stay, or office visit,” he explained. “We often attribute the payer (insurance cost), but this does not accurately represent the cost to the provider, which is the true cost of delivery.”
In a new study, Portney and his coworkers hypothesized “that there was an excess cost associated with complex [cataract] surgeries that was not adequately covered in reimbursement.”
To prove this, they used a method they called “time-driven activity-based costing” to measure the…
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