Abstract
Purpose :
Retinal detachment (RD) is a sight-threatening condition that requires prompt treatment to prevent permanent vision loss. Understanding RD repair procedures practice patterns and shifts in reimbursements can improve patient outcomes and optimize healthcare resource allocation.
Methods :
In this cross-sectional population-based study, we included geographical and provider-level data on RD repair procedures from the Medicare Fee-For-Service Provider Utilization and Payment Part B from 2013 to 2021. Additionally, we analyzed changes in insurance reimbursements for these procedures over time, utilizing Current Procedural Terminology codes for pars plana vitrectomy (PPV), complex repair, scleral buckle (SB), pneumatic retinopexy (PR), photocoagulation, and cryotherapy.
Results :
Between 2013 and 2019, we observed a 7.5% increase in the rate of RD procedures, rising from 15.2 to 16.3 procedure per 10,000 Medicare beneficiaries. The onset of the COVID-19 pandemic in 2020 resulted in a 8.8% decline in the total number of procedures, with incomplete recovery in 2021. Notably, PR stood out as the least affected procedure by the pandemic with a 6.6% reduction in 2020. PPV and complex repair procedures emerged as the most common procedures across all geographical regions, displaying a rising trend over time. In contrast, other procedures exhibited a decreasing trend, with cryotherapy undergoing the most substantial decline, decreasing from 1.4% of all procedures in 2013 to 0.6% in 2021 (56.8% decrease).
Medicare reimbursements for RD repair procedures showed a 29% decrease over time with significant negative correlations between time and payments for cryotherapy (rho=-0.73, p=0.02), photocoagulation (rho= -0.95, p<0.001), SB (rho= -0.86, p=0.002), PPV (rho= -0.95, p<0.001), and complex repair (rho= -0.98, p<0.001). These correlations suggest a consistent decreasing trend in reimbursements for these procedures.
Conclusions :
Pars plana vitrectomy has evolved as the predominant procedure over time across all geographical regions. The decrease in Medicare reimbursements, along with patient and surgeon-related factors, significantly impact the trends in RD repair.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.