title: Joint Management of Cataract Surgery by Ophthalmologists and Optometrists.
abstract: OBJECTIVE
  To estimate the rate and geographic variation of cataract surgery that is managed jointly by ophthalmologists and optometrists in aging Americans.
  
  
  METHODS
  Database study.
  
  
  METHODS
  United States fee-for-service (FFS) Medicare Part B beneficiaries and their providers.
  
  
  METHODS
  Medicare Provider Utilization and Payment Data furnished by the Centers for Medicare and Medicaid were used to identify cataract surgery claims among FFS Medicare Part B beneficiaries in all 50 states and the District of Columbia in 2012 and 2013. Payments and joint management rates of cataract surgery by ophthalmologists and optometrists were calculated for each United States state. Geographic variations were evaluated by using the extremal quotient and coefficient of variation (CV).
  
  
  METHODS
  Medicare allowed payments for cataract surgery (Current Procedural Terminology codes 66982 and 66984) and number of unique FFS Medicare Part B beneficiaries undergoing cataract surgery.
  
  
  RESULTS
  The overall national rate of joint management of cataract surgery by ophthalmologists and optometrists among FFS Medicare Part B beneficiaries was 10.9% (range by state, 0%-75%) in 2012 and 11.1% (range by state, 0%-63%) in 2013. In 2013, the mean extremal quotient was 67 and the CV was 82.2, demonstrating very high variation in joint management between states. The Medicare allowed payment to optometrists in the joint management of cataract surgery was 2.1% of the total Medicare allowed payments for cataract surgery codes in 2012 and 2013. Twenty percent and 24% of all Medicare-participating optometrists submitted 10 or more Medicare claims in the joint management of cataract surgery in 2012 and 2013, respectively.
  
  
  CONCLUSIONS
  The overall rate of joint management of cataract surgery by ophthalmologists and optometrists among Medicare beneficiaries was 10.9% in 2012 and 11.1% in 2013. Very high geographic variation was documented, with joint management rates ranging from 0% to 63% across states in 2013.
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota. Electronic address: erie.jay@mayo.edu.
authors.forename: Jay C
authors.initials: JC
authors.lastname: Erie
authors.affiliation: Department of Health Science Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: David O
authors.initials: DO
authors.lastname: Hodge
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mahr
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D014487:Centers for Medicare and Medicaid Services, U.S.; D003266:Continuity of Patient Care; D039702:Current Procedural Terminology; D016208:Databases, Factual; D018588:Fee-for-Service Plans / Q000706:statistics & numerical data; D005260:Female; D005843:Geography; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D016345:Medicare Part B / Q000706:statistics & numerical data; D009885:Ophthalmology / Q000191:economics / Q000706:statistics & numerical data*; D009907:Optometry / Q000191:economics / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States