As president of the Ohio Ophthalmological Society (eye physicians and surgeons), I write in response to last Saturday's Dispatch article "Database shows Medicare payments to local doctors."
As president of the Ohio Ophthalmological Society (eye physicians and surgeons), I write in response to last Saturday’s Dispatch article “Database shows Medicare payments to local doctors.”
The society supports sharing information that might improve patient outcomes, but to use this raw data as a tool to set a doctor’s compensation or to attempt to draw any conclusions about the relationship between cost and quality is inappropriate.
Specifically, looking at what a physician is paid in the aggregate by Medicare, as this data does, gives the end user no sense of the comparative cost of care.
For example, in ophthalmology many retina specialists purchase medications that are injected into patients’ eyes to treat diseases such as macular degeneration.
Unlike with drugs obtained at a pharmacy by the patient, the physician purchases the medication and then bills Medicare for the cost, which can be up to $2,000 per injection. This reimbursement shows up as income to the doctor in the Medicare Payment Database, but the doctor actually receives only about $100 for performing the injection.
This inflates individual-payment data by hundreds of thousands of dollars each year.
Additionally, most ophthalmologists see predominantly elderly patients, so Medicare payments make up the majority of their practice reimbursement, while many other specialties have a much more diverse group of patients and payers.
In summary, the Ohio Ophthalmological Society will continue to work with patients and policymakers to ensure disclosure of accurate and useful information about cost and quality to the public, rather than the raw data sets recently released, which are both incomplete and misleading.
DR. JAMES SILONE JR.