Abstract
Purpose :
To investigate the effect of provider gender on Medicare reimbursement rates across ophthalmologic subspecialties, and the field in entirety.
Methods :
We collected reports from the Center for Medicare and Medicaid Services from 2013-2020 which break down the reimbursement rates for each provider by their primary specialty and Medicare Part B Healthcare Common Procedure Coding System (HCPCS) service codes. Ophthalmologists were grouped into glaucoma, corneal, vitreoretinal, cataract, or comprehensive subspecialties if the physician performed at least ten procedures from a set of representative HCPCS codes for each given subspecialty. Within each subspecialty, we grouped the providers by gender and determined the yearly average total reimbursement, average reimbursement per patient, and the total reimbursement per provider per HCPCS code, and the gender ratio.
Results :
In 2020, female glaucoma specialists were reimbursed on average 68.35%, as much as their male counterparts, an improvement from 63.27%, in 2013. Female corneal, vitreoretinal, and cataract surgeons were reimbursed 60.40%, 64.69% and 73.02% as much as their male counterparts, compared to 60.34%, 72.49% and 57.79% respectively in 2013. Among glaucoma specialists there were 3.94 male providers for each female provider in 2020. In the same year the male to female provider ratio was 3.76:1 for cornea specialists, 3.16:1 for cataract surgeons, and 10.14:1 for vitreoretinal surgeons. In 2020, across the entire specialty, female physicians were reimbursed 48.85% as much as male physicians, compared to 49.65% in 2013. For each female ophthalmologist there were 3.83 male ophthalmologists.
Conclusions :
On average female ophthalmologists are reimbursed through Medicare less than half as much as their male counterparts. When reimbursement was controlled by subspecialty, this disparity improved to 60-73%. However, this improvement masks the increased gender disparity in physician representation in multiple subspecialties relative to the average across all ophthalmologists. This is potentially indicative of disparity in the subspecialty female and male ophthalmology residents are choosing to apply for, or are encouraged to specialize in. Additionally, across the eight years for which data is available, there is only moderate improvement in the reimbursement within subspecialties, and the disparity in reimbursement across all ophthalmologists grew larger.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.