Predicted and observed effects of the Medicare Optometry Parity Amendment

The Medicare Parity Amendment of 1987 redefined the conditions of optometric participation and expanded coverage to include all Medicare-covered services which optometrists are authorized to perform under state law. Prior to the law, a number of studies projected costs to Medicare as a result of a change in Medicare policy. This paper reviews these studies in relation to actual Medicare expenditures from 1986 to 1988. The paper describes the impact of the Medicare amendment on payments to optometrists and shows how payments increased from $12 million in 1986 to $81 million in 1988. Optometrists substantially increased their market share of Medicare payments from 2.6 percent in 1986 to 11.1 percent in 1988. Indications suggest that a shift of patient visits from ophthalmologists to optometrists has occurred.