Replacing visual acuity screenings for dilated eye exam cost effective

According to a study published online initially in the Archives of Ophthalmology, it has been suggested that it would be highly cost-effective” to swap visual acuity screenings for new Medicare enrollees with coverage of a dilated eye exam. This is meant for healthy patients who have registered for the government insurance program for the elderly.

At the age of 65 years, individuals are eligible to enroll in Medicare. As part of a Welcome to Medicare health evaluation, within 12 months of enrollment, they are due to be given a visual acuity screening and other preventive health checks. The U.S. Preventive Services Task Force repealed its 1996 proposal in 2009, in favor of visual acuity screening, because of inadequate evidence to support it. At present, it is not decided whether Medicare will continue to include visual acuity screening in its initial preventive physical examination.

The findings of research undertaken by David B. Rein, Ph.D., of Public Health Research at NORC at the University of Chicago, and his team, point out that dilated eye evaluations improved quality-adjusted life years (QALY) by 0.008 and increased costs by $94, when compared with a no-screening policy. The researchers recognized that visual acuity screening raised QALYs in less than 95% of the simulations with an increase in total costs of $32 per person.

They came to the conclusion that the policy of visual acuity screening does not fully utilize the resources and that substituting this policy with coverage of a dilated eye evaluation for all healthy patients newly enrolled to Medicare would be highly cost-effective.

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