Abstract
Purpose :
Ophthalmic telemedicine has demonstrated potential for continued use; however, regional variation has not yet been characterized. This analysis aims to quantify regional telemedicine utilization from 2019-2020.
Methods :
The Centers for Medicare and Medicaid Services (CMS) Public Use File (PUF) 2019-2020 was used to determine telemedicine claims for ophthalmologists. Telemedicine visits were identified with 4 types of codes: Evaluation and Management (E/M) codes, Eye codes, telephone E/M codes, and virtual check-ins and e-visits codes. Within regions, one-sample t-tests were used to investigate whether telemedicine claims were significantly different between 2019 and 2020. To determine whether there were significant differences in telemedicine claims between US regions, negative binomial regression were done. Adjustment for density of ophthalmologists, population size, US Region, and Medicare claim charges were conducted. All statistical analyses were performed in IBM SPSS Version 28. Statistical significance was achieved at p<0.05.
Results :
In 2019, there were nearly 20 million ophthalmology office visits; however, a 20.4% decrease was observed during the first year of the pandemic (2020). Telemedicine claims experienced an increase from 32 to 98,045 across years, representing an increase in claims rate per 100,000 residents by 32.2 (p<0.001) (Table 1). After adjusting for total Medicare allowed charges per state, average number of ophthalmologists per state, and state population sizes, there was a 133% and 160% increase in telemedicine claim rate in the South (incidence rate ratio [IRR] 2.33, 95% CI 1.02 – 5.33, p=0.05) and Northeast (IRR 2.60, 95% CI 0.98 – 6.90, p=0.06) compared to the West, respectively (Table 2). There was a non-significant increase in telemedicine use in the Midwest (IRR 1.13, 95% CI 0.47 – 2.70, p=0.79) compared to the West.
Conclusions :
In the context of the COVID-19 pandemic, understanding regional variations of ophthalmic telemedicine use may help to guide healthcare delivery. Nationally, ophthalmic use of all telemedicine coding systems significantly increased in 2020. In 2020, regional utilization was greater within the Northeast and South. Clinicians and policymakers should consider these regional differences in healthcare delivery when proposing improvements to healthcare infrastructure.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.