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April 1990

Cataract PPOs

Author Affiliations

Baltimore, Md

Arch Ophthalmol. 1990;108(4):501-502. doi:10.1001/archopht.1990.01070060049045

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The high profile of cataract surgery continues to make it a prime target for fee cuts and reimbursement initiatives by the Health Care Financing Administration (HCFA). Congress has made it clear that Medicare spending cuts will be one method to help decrease the federal deficit, and because HCFA is now reimbursing for more than 1 million cataract surgeries a year, accounting for 12% of all Medicare payments, it has become the subject of much attention.

While it is commonly called the "Cataract PPO" project, the Office of Research and Demonstrations of HCFA is actually developing an "Alternative Cataract Surgery Payment Demonstration Project" with help from Abt Associates, Cambridge, Mass. HCFA considers this an experiment in how "bundling" will affect availability, efficiency, and quality, as well as price. While still being designed, the project will designate three geographic areas (probably urban) from which bids will be solicited from providers willing to

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