Dilated Eye Exams More Cost Effective Than Visual Acuity Screening for Medicare Enrollees

Medicare currently covers visual acuity screenings for patients at the time of enrollment, but a new study suggests dilated eye examination would be more cost effective, according to findings published in the Archives of Ophthalmology.

Researchers conducted a stimulation model with 50,000 new Medicare enrollees with no diagnosed eye disorders and found dilated eye evaluations increased quality-adjusted life-years by 0.008 and increased costs by $94. A visual acuity screening increased QALYs in less than 95 percent of the simulations and increased total costs by $32.

Compared with no screening, the cost-effectiveness ratio of visual acuity screening was $20,300 per QALY from the perspective of the patient, $7,400 from the perspective of Medicare and $29,100 from the society perspective. For dilated eye examinations compared with acuity screening, the cost-effectiveness ratio was $3,400 per QALY from the patient's perspective, $5,300 from the perspective of Medicare and $9,500 from the society perspective. Researchers calculated that if two million new patients enroll in Medicare each year, the increase in QALYs would be 2,200 for visual acuity screening and 15,200 for dilated eye examinations.

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