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July 1997

Should Rates of Cataract Surgery Vary by Insurance Status?

Author Affiliations

From the Department of Ophthalmology, Lenox Hill Hospital, New York, NY.; Corresponding author: Stephen A. Obstbaum, MD, Department of Ophthalmology, Lenox Hill Hospital, 100 E 77th St, New York, NY 10021 (e-mail: LHHEyeDept@aol.com).

Arch Ophthalmol. 1997;115(7):917-918. doi:10.1001/archopht.1997.01100160087017


Variations in Cataract Extraction Rates in Medicare Prepaid and Fee-for-Service Settings

Caroline Lubick Goldzweig, MD, MSPH; Brian S. Mittman, PhD; Grace M. Carter, PhD; Tenzing Donyo, MBA; Robert H. Brook, MD, ScD; Paul Lee, MD, JD; Carol M. Mangione, MD, MSPH

Objective.  —To compare rates of cataract extraction in 2 prepaid health settings and in traditional fee-for-service (FFS) settings.

Design.  —A cross-sectional analysis using 1993 health maintenance organization (HMO) Medicare claims and encounter files, the Health Care Financing Administration (HCFA) 5% Medicare Part B provider/supplier file, and the HCFA October 1992 100% Medicare population file.

Setting.  —Southern California Medicare FFS settings and the staff-model and independent practice association (IPA) plans of a large California HMO.

Patients.  —1993 Medicare beneficiaries aged 65 years and older. The study included 43 387 staff-model HMO enrollees, 19 050 IPA enrollees, and 47 150 FFS beneficiaries (a 5% sample of all Southern California FFS

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