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Home E-Weekly April 21, 2015

Unnecessary Testing Inflates Cataract Surgery Costs

Published: April 20, 2015

If you or your physicians are still routinely ordering pre-operative testing to prepare patients for cataract surgery, some experts, insurers and patients would like to have a word with you.

Stop.

A study in the April 16 issue of the New England Journal of Medicine finds that even though previous major studies have found that routine testing improves neither safety nor outcomes, and that several medical groups have advised against it since 2002, most cataract patients are still being ordered to get at least one test in the month before surgery, and many are being subjected to a battery of blood tests, chest X-rays, electrocardiograms, and heart and lung tests.

The researchers looked at the Medicare records of more than 440,000 patients from 2011 and found that 53% had had at least one test done in the month before cataract surgery. Shockingly, 13% were told to have 5 or more tests.

The cost of all that unnecessary testing? Millions of dollars, to both Medicare and to patients, who are generally responsible for co-pays of about 20%.

The biggest factor, say the researchers, had nothing to do with patient characteristics. Instead, it was dictated by the habits of the physicians doing the ordering. In fact, a relatively small percentage of physicians were responsible for more than 84% of the tests, and 36% of physicians ordered tests for at least 75% of their patients.

Jim Burger

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