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Abstract #145762
Audio (mp3) recordingAlan R. Morse, PhD, President and CEO, The Jewish Guild for the Blind, 15 W. 65 Street, New York, NY 10023, 212-769-6215, armorse@jgb.org and Bruce Pyenson, FSA, MAAA, Milliman, Inc, 1 Penn Plaza 38th Fl., New York, NY 10019.
We analyzed the public use data set of the Program of All-Inclusive Care for the Elderly (PACE) whose participants are all eligible for Medicaid and Medicare Parts A & B and are at least age 55 to determine if Medicare/Medicaid beneficiaries with vision impairment are at an increased risk for medical care cost than are similar beneficiaries without visual impairment. Hierarchical Condition Category (HCC) risk adjustors were calculated using diagnosis codes from the populations' inpatient admissions. Vision impairment was defined as “Cannot see at all or sees some light or shadows but vision is so poor that the participant is not able to see obstacles in his or her path” which means that to be considered visually impaired, a participant would most likely be legally blind. Other studies have shown that severe vision loss, whether itself, as comorbidity, or as sequelae of disease processes, increases healthcare cost. This analysis provides evidence that PACE participants with severe visual impairment are at an increased risk for healthcare cost. The increase in medical cost risk overall for visually impaired PACE participants was 10%, but rose to 13% for the non-institutionalized, community-based, cohort. For PACE participants in institutions i.e., nursing homes, the risk was about the same for those with and without, vision loss. Health care cost risk attributable to vision loss is probably not adequately captured by Medicare HCC risk adjustment method which may understate the excess health care cost by individuals with severe visual impairment.
Learning Objectives:
- Recognize the impact of vision loss on healthcare costs in an aged population
- Articulate the influence of co-morbidities,when accompanied by vision loss, on healthcare
- Identify methodological difficulties in studying the impact of vision loss
- Discuss ways to reduce excess healthcare expenditures that relate to vision loss
Keywords: Vision Care, Health Care Utilization
Presenting author's disclosure statement:
Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA