By Phil Galewitz, KFF Health News
This story was originally published by KFF Health News.
Tammy Chalala, a retired dietitian in New York, was thrilled with the results of her cataract surgeries, which left her with close to 20/20 vision. She said she paid nearly $4,000 out-of-pocket for her two surgeries last year because she opted to have her doctor use a laser to assist with the procedure.
Why It Matters: Cataract surgery, one of the most common operations paid for by Medicare, typically leaves enrollees owing a few hundred dollars. But a growing number of patients are paying thousands more out-of-pocket simply because they agree to have their doctor use a laser rather than the traditional scalpel method. Both methods are safe and can significantly reduce or eliminate the need for glasses, but many doctors say the laser makes more precise cuts, and recoups more revenue as Medicare has gradually cut what it pays for the procedure.
The Financial Incentive: Oliver Schein, an ophthalmologist at Johns Hopkins Medicine, points to the strong financial incentive to use the laser, since the equipment can cost a practice up to $500,000. Barbara Cobuzzi, 71, a medical billing consultant with traditional Medicare, said her New Jersey eye doctor recommended a $1,500-per-eye laser surgery; she got a second opinion, had the procedure done without a laser, and was happy with the results. “Doctors are using the laser as a moneymaker,” she said.
The Other Side: Vance Thompson, a past president of the American Society of Cataract and Refractive Surgery, said about half his patients now choose the laser, up from roughly 10% a decade ago, and that patients “deserve to be educated on all their options.” A UCLA ophthalmologist said 80% of patients at his practice in an affluent part of Los Angeles opt for the laser, though he acknowledged it “does not make vision better,” comparing the choice to buying “a Toyota Camry or buying a Lexus.”
The Caveat: The laser isn’t suitable for all patients, including those with corneal scarring or a small pupil. And it’s difficult to prove the laser’s added benefit, since traditional cataract surgery is already safe and effective with low infection rates, said one Toronto-based ophthalmologist.
Read the full story at kffhealthnews.org.
KFF Health News is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KFF Health News is one of the core operating programs of KFF, an independent source of health policy research, polling, and journalism. Learn more about KFF.