title: Medicare reimbursement to ophthalmologists: a comparison of Hawai'i to other states.
abstract: When Medicare publically released data on payments made to specific physicians in April of 2014, it quickly became apparent that a large portion of 2012 Medicare reimbursements went to ophthalmologists. Part of the reason for this unusually high level of reimbursement was thought to be the cost of injectable drugs such as ranibizumab (brand name Lucentis). This study was designed to compare Hawai'i ophthalmologists' Medicare reimbursements with those of other states. In 2012, Medicare payment to ophthalmologists in Hawai'i was $18.2 million. Hawai'i ranked third in the nation in terms of percentage of total reimbursement going to ophthalmologists at 11.1% and 34th (8.2%) in percentage of ophthalmologist reimbursements going to injectable biological products. Hence, the high percentage of reimbursement going to ophthalmologists in Hawai'i is unlikely due to high use of injectable medications. Further research, based on a more detailed analysis of clinical data, is needed to determine how to slow the growth of health care costs while promoting high-value, effective care, not only for ophthalmic services but in other high-cost areas as well.
authors.affiliation: Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, Hilo, HI (DTJ, AG).
authors.forename: Deborah Taira
authors.initials: DT
authors.lastname: Juarez
authors.affiliation: Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, Hilo, HI (DTJ, AG).
authors.forename: Alexander
authors.initials: A
authors.lastname: Guimaraes
authors.affiliation: Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, Hilo, HI (DTJ, AG).
authors.forename: Brendan
authors.initials: B
authors.lastname: Seto
authors.affiliation: Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, Hilo, HI (DTJ, AG).
authors.forename: James W
authors.initials: JW
authors.lastname: Davis
mesh_terms: D006254:Hawaii; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000592:standards*; D006278:Medicare; D009885:Ophthalmology / Q000191:economics*; D014481:United States