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Delaying progression of diabetic retinopathy may help decrease Medicare costs
Retina. 2009;29(2):199-206.
An analysis of Medicare costs associated with diabetic retinopathy found substantial expenditures associated with the proliferative form of the disease. Therefore, delaying progression may be beneficial from a cost perspective.
Medicare payments associated with proliferative retinopathy totaled $13,806 on average, higher than average payments for nonproliferative cases ($10,163) and patients with a diagnosis of diabetes but no evidence of retinopathy (control group, $9,981).
Only part of the total cost of care, however, was due to claims specifically for ophthalmic services, according to the study. On average, Medicare paid about $1,223 for proliferative cases, $297 for nonproliferative cases and $90 for control patients.
While the analysis may overestimate the direct cost of caring for patients with diabetic retinopathy — the researchers used information from patient databases and so there was no way to directly relate expenditures to care for diabetic retinopathy — total ophthalmic expenditures for patients without diabetes were similar to expenditures for control patients in the study, indicating that differences in the two case groups were related to retinopathy care.