Medicare cuts could force rural Indiana eye doctors to close

Vision loss is one of the most feared medical outcomes possible, second only to death and cancer in surveys of the most feared medical diagnoses. Nearly 80% of the data transmitted to our brain comes from our eyes, and we rely on vision for most activities in our daily lives. Elderly patients with impaired vision are at greater risk of developing dementia or falling, and eye health is critical to the overall health of older adults.

Unfortunately, the government is about to make it harder for seniors to access quality eye care due to shortsighted and misguided Medicare cuts.

The Centers for Medicare & Medicaid Services (CMS) announced a new rule which significantly reduces surgical care from January 2022. This includes the reduction of post-operative visits, an absolute necessity in vision procedures.

Many eye conditions are associated with aging, so between 60 and 80 percent of an eye doctor’s patients receive Medicare or Medicaid. We depend on Medicare reimbursement to sustain our practice and continue to provide world-class care to our patients.

I have been practicing ophthalmology in Indianapolis for over 20 years. Most of my time is spent serving my patients and my community, but about 30% of my work is dedicated to research and education. This time allows me to improve the care I provide by developing new treatment strategies as well as by training young doctors. However, this time is not reimbursed and if Medicare payments are reduced, the time that can be set aside for these valuable activities will have to decrease.

With the COVID-19 pandemic, our practice not only had to increase expenses for office operations and PPE, but also had to deal with increased personnel costs. Even without the Medicare cuts, it has been much more difficult for independent practices like ours. Last year, a national survey found that one in three private surgical practices were considering closing due to financial pressures from the pandemic.

A huge decrease in practice revenue and reimbursements during a time of rising costs will almost certainly lead to practice consolidation at the expense of patient access to care. Small centers will grapple with higher costs, and payment cuts could be the last straw for many rural surgeons.

Large facilities and metropolitan hospitals will absorb smaller private practices, reducing the number of providers who can serve Medicare patients in rural communities and forcing patients to travel farther for treatment.

If surgeons start to close shop in a small American town or take on fewer Medicare patients than before, everyone in that community will bear the brunt. We all rely on our vision in everyday life, but if care is unattainable, patients can also forego care altogether and end up with poorer outcomes.

Congress must act now to stop these damaging cuts from taking effect. Not only will we save countless small businesses, but we will also help our most vulnerable population maintain access to high quality surgical care. Now is not the time to make cuts to Medicare, so we all need to speak up and tell Congress to stop the cuts.

Raj Maturi is an ophthalmologist in Greenwood, Indiana.