Will your facility and surgeons be ready when it does? Patients
already are.
Eighty percent of cataract patients would prefer to have both their
eyes done at once, according to a paper presented at a recent ASCRS
meeting. But several barriers are blocking same-day bilateral cataracts
from becoming commonplace.
• Reimbursements. A study conducted by Rush Eye Associates in
Amarillo, Texas, compared post-op outcomes and the economics of
same-day bilateral cataract surgery and separate-day procedures
(osmag.net/RsyCE6). The findings show patients who underwent
same-day bilateral cataract surgery spent less time traveling for care,
required fewer total care visits and recovered post-op vision faster.
Facilities and physicians made less than they would have by operating
on separate days, but treating both eyes at the same time saved health-
care dollars.
Surgeons don't always have to be left holding the short end of the
stick, however. Each time a surgeon with the Colorado Permanente
Medical Group performs same-day bilateral cataract surgery, he earns
more for himself. How? Kaiser Permanente uses capitation payments,
which are based on a fixed payment per person, rather than a pay-
ment per service. The economics must improve for surgeons in pri-
vate practice before same-day bilateral cataract surgery truly catches
on, but the success of the Colorado Permanente group backs
Medicare's interest in bundled payments and accountable care organi-
zations, which are shifting the focus to more efficient and cost-effec-
tive care.
• Safety. I was the founding president of the International Society of
Bilateral Cataract Surgeons (isbcs.org), which was launched in 2008 to
let surgeons who perform same-day bilateral cataract surgery share their
experiences and best practice ideas, and to provide physicians with
8 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 6