June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Comparing utilization for inflammatory and infectious eye diseases for Medicare and Commercial insurance
Author Affiliations & Notes
  • Krati Chauhan
    Southern Illinois University School of Medicine, Springfield, Illinois, United States
  • James T Rosenbaum
    Oregon Health & Science University, Portland, Oregon, United States
    Legacy Health System, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Krati Chauhan None; James Rosenbaum Abbvie, Novartis, Gilead, Roche, Affibody, Immune Response, Kyverna, Santen, Corvus, Horizon, Revolo and Neoleukin , Code C (Consultant/Contractor), Horizon and Pfizer, Code F (Financial Support), UpToDate, Code R (Recipient), Celgene-Bristol Myers, Code S (non-remunerative)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2140 – A0168. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Krati Chauhan, James T Rosenbaum; Comparing utilization for inflammatory and infectious eye diseases for Medicare and Commercial insurance. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2140 – A0168.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Eye health is influenced by access to eye care. Eye care in the United States is covered by health insurance plans, either private or made available by government. Medicare is provided by government and Marketscan is a private or commercial insurance. Utilization of eye care is impacted by type of insurance a person has. There is lack of data, comparing utilization for infectious and inflammatory eye diseases among those who have Medicare and private insurance. We have conducted a retrospective study, using Medicare and Marketscan to evaluate this comparison

Methods : We have used Medicare and Marketscan data available through National Vision and Eye Health Surveillance System (VEHSS). Medicare is funded by government and covers eye services for nearly the entire US population aged 65 years or older and some < 65 years. The MarketScan Commercial Claims and Encounters (CCAE) data has insurance information from persons with employer-sponsored insurance.
VEHSS uses ICD-10 codes to identify ocular disorders. Each code is categorized in one subgroup and multiple subgroups are combined to form a category. Inflammatory and infectious eye disease category includes subgroups of ocular inflammatory conditions, lacrimal system and orbital inflammation, keratitis, conjunctivitis, eyelid inflammation and infection, and endophthalmitis.
Utilization for Medicare and Marketscan is compared for the year 2016. Utilization for the inflammatory and infectious eye disease category is stratified by age and sex for the two databases

Results : There were 30,423,400 million Medicare beneficiaries and 28,717,700 commercial insurance enrollees in 2016. Annual utilization for Medicare was higher 11% (95% CI: 11.00-11.00) as compared to Marketscan 5.22% (95%:5.21-5.23), and differences remained after stratification by age (data shown in Table).
For both Market scan, females 5.90% (95% CI: 5.89-5.91) vs males 4.50% (95% CI: 4.49- 4.51) and Medicare, females, 13.30% (95% CI: 13.30-3.30) vs. Males, 9.40% (95% CI: 9.30- 9.40), females had higher utilization

Conclusions : Medicare beneficiaries have higher utilization as compared to commercial insurance. This remains when data are stratified by age and sex. Our results are consistent with prior studies that indicate higher utilization in general for Medicare.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Table: Utilization for infectious and inflammatory eye diseases by age: Medicare and Commercial Insurance: 2016

Table: Utilization for infectious and inflammatory eye diseases by age: Medicare and Commercial Insurance: 2016

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×