Optometric and ophthalmological eye care under the Medicare program

A questionnaire survey was administered to more than 600 elderly persons within several senior citizens centers in New York City. Data was collected on the elderly's use of eye care services, particularly the site where eye care was obtained, the type of provider chosen and the source of payment, i.e. Medicare, Medicaid or self pay. The second stage of the survey was to screen all participants for the absence or presence of visual problems. Significant differences were found when comparing the use of optometrists and ophthalmologists with the method by which the respondent paid for their last eye examination. Among those who were seen by an ophthalmologist and reported that Medicare paid for their examination half either passed or failed the vision screening test due only to poor visual acuities. Statistical evidence seems to indicate that Medicare payments to ophthalmologists may not be solely for actual or suspected disease conditions. Implications for the Medicare program seem evident.