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Practice Management

Rising trend of Medicare opt-outs among eye care professionals, study finds

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An increasing number of ophthalmologists and optometrists have opted out of Medicare since 2012, despite the overall percentage remaining relatively low, according to a study.

The retrospective cross-sectional study used data from the Centers for Medicare & Medicaid Services (CMS) spanning from 2005 to 2023. The research found that only a small percentage of ophthalmologists (0.52%) and optometrists (0.38%) chose to opt out of Medicare during this period.

Key findings showed that:

Of the ophthalmologists who opted out:

  • 67.5% were male
  • Average of 31.8 years in practice
  • 83.1% were located in urban areas

Of the optometrists who opted out:

  • 53.2% were male
  • Average of 19.6 years in practice
  • 41% were located in non-urban areas

Specialty and practice type:

  • 83% of ophthalmologists were in anterior segment or oculoplastics specialties
  • 52.1% of optometrists were in optometry-only practices

Geographical distribution:

  • States with the highest opt-out rates for both professions included Oklahoma, Idaho, and Montana

The study highlights the need for further investigation into the reasons behind Medicare opt-out decisions and their potential impact on patient access to care.

Reference
Maywood MJ, Ahmed H, Parikh R, et al. Opting out of Medicare: Characteristics and differences between optometrists and ophthalmologists. PLoS One. 2024;19(9):e0310140. doi: 10.1371/journal.pone.0310140. PMID: 39250498.