To calculate the associations between Medicare payment and service volume for complex and noncomplex cataract surgeries.
The 2005–2009 Part B National Summary Data Files, Part B Carrier Summary Data Files, and the Medicare Physician Fee Schedule.
Conducting a retrospective, longitudinal analysis using a fixed‐effects model of Medicare Part B carriers representing all 50 states and the District of Columbia from 2005 to 2009, we calculated the Medicare payment–service volume elasticities for noncomplex ( 66984) and complex ( 66982) cataract surgeries.
Service volume data were extracted from the Part B National Summary and Carrier Summary Data Files. Payment data were extracted from the Medicare Physician Fee Schedule.
From 2005 to 2009, the proportion of total cataract services billed as complex increased from 3.2 to 6.7 percent. Every 1 percent decrease in Medicare payment was associated with a nonsignificant change in noncomplex cataract service volume (elasticity = 0.15, 95 percent [−0.09, 0.38]) but a statistically significant increase in complex cataract service volume (elasticity = −1.12, 95 percent [−1.60, −0.63]).
Reduced Medicare payment was associated with a significant increase in complex cataract service volume but not in noncomplex cataract service volume, resulting in a shift toward performing a greater proportion of complex cataract surgeries from 2005 to 2009.