PubMed Health⌕ Search

Biomedical subjects

M Soroka

Publications and source records attributed to M Soroka.

At least 19 recordsLinked to original sources
PubMed1994

Guideline development process for optometric care of the patient with diabetes mellitus. American Optometric Association.

BACKGROUND: The aim of this project was to develop a standard of optometric care for patients with diabetes mellitus in an effort to help the clinician bridge the gap between research and practice. These guidelines are intended to assist optometric practitioners in the prevention, diagnosis, treatment, management, and rehabilitation of their patients. The guidelines are based on the best available research and professional judgment regarding the effectiveness and appropriateness of optometric care and procedures. METHODS: This paper details the methodology used by the AOA's Clinical Guidelines Coordinating Committee, Consensus Panel and the Center for Vision Care Policy of the State College of Optometry, SUNY, to develop practice guidelines for patients with diabetes mellitus.

Diabetes Mellitus↗
PubMed1994

Long term follow up after percutaneous mitral commissurotomy with the Inoue balloon-incidence of restenosis.

UNLABELLED: The long term outcome of 300 consecutive patients following percutaneous mitral commissurotomy (PMC) with the Inoue balloon was analyzed with regard to the incidence of restenosis. There were 256 females and 44 males (mean age 44.4 +/- 9.9 years, range 18-69 years), 52 had previous surgical commissurotomy, 96 were in atrial fibrillation, and 16 had a history of embolism. PCM was carried out with a success rate of 84% (no significant mitral regurgitation and mitral valve area (MVA) > 1.5 cm2). Two hundred and seventy patients were available for clinical and serial echocardiographic studies at six months, 12 months and once a year thereafter (18 patients operated on for mitral regurgitation less than six months after PMC, three patients lost to follow up, nine patients refused to return). MVA increased with PMC from 1.18 cm2 +/- 0.3 to 2.0 +/- 0.3 cm2 and then decreased to 1.8 +/- 0.3 at a mean follow up of 24.0 +/- 13.5 months (range 6-55). Echocardiographic restenosis (RS) (MVA at follow up < 1.5 cm2 with a 50% loss of the initial gain) was found in 38 patients (14%). Twenty-five (66%) of them remained in NYHA class I or II. Restenosis free survival according to the Kaplan-Mayer curve was 93%, 86%, 77% and 73% at 12,24,36 and 55 months respectively. None of the 24 clinical, hemodynamic, echocardiographic or procedural variables used on the Cox proportional hazard regression analysis identified predictors of restenosis free survival. CONCLUSIONS: The overall incidence of echocardiographic restenosis post PMC is low (12.6%) in patients followed for a mean period of two years and often occurs without worsened clinical symptoms. It may be difficult to define clinical, echocardiographic or procedural factors as significant predictors of restenosis free survival.

Adolescent↗
PubMed1992

Specialty differentials, limited license practitioners, and Medicare's new fee schedule.

The use of specialty differentials in the newly adopted Medicare fee schedule has been debated over the past 2 years. Arguments supporting the elimination of specialty differentials for optometrists and ophthalmologists are presented. The first recommendations by the Physician Payment Review Commission eliminating specialty differentials represent a victory for optometry in its efforts to achieve parity in the reimbursement of Medicare-covered services. Relative value units and practice costs to be used by the new Medicare fee schedule must be determined for optometry. Estimates of the model fee schedules for eye care procedures have been released by the Department of Health and Human Services.

Economics, Medical↗
PubMed1991

Standards of care.

The health care community is quickly progressing in the direction of the development and acceptance of the concept of standards of care. Optometry has lagged behind other health disciplines in this process and must develop its own or face the likelihood of having to conform to standards created by others. The argument is no longer whether standards should be created, but rather the creation of appropriate standards and guidelines that will best serve the profession and the public.

Humans↗
PubMed1991

A comparison of charges by optometrists and ophthalmologists under the Medicare program.

Medicare data obtained from the Health Care Financing Administration was analyzed in relation to average allowed charges by optometrists and ophthalmologists. Optometric charges are considerably lower than ophthalmological charges for all services compared. The policy of different reimbursement levels is currently a major issue being considered by the Physician Payment Review Commission. Optometry must demonstrate that the procedure codes for which they submit Medicare claims are comparable and identical in service content to those provided by ophthalmologists.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1991

Predicted and observed effects of the Medicare Optometry Parity Amendment.

The Medicare Parity Amendment of 1987 redefined the conditions of optometric participation and expanded coverage to include all Medicare-covered services which optometrists are authorized to perform under state law. Prior to the law, a number of studies projected costs to Medicare as a result of a change in Medicare policy. This paper reviews these studies in relation to actual Medicare expenditures from 1986 to 1988. The paper describes the impact of the Medicare amendment on payments to optometrists and shows how payments increased from $12 million in 1986 to $81 million in 1988. Optometrists substantially increased their market share of Medicare payments from 2.6 percent in 1986 to 11.1 percent in 1988. Indications suggest that a shift of patient visits from ophthalmologists to optometrists has occurred.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1991

The Medicare Optometry Parity Amendment: predicted and actual payments to optometrists and ophthalmologists.

This paper compares various costs estimates for the expansion of optometric services under the Medicare program that were developed prior to the enactment the Medicare Parity Amendment of 1986. The new law, effective April 1, 1987 redefines the conditions of optometric participation and expanded coverage to include all Medicare covered services for which optometrists are authorized to perform under the state law. The paper describes the impact of the Medicare amendment with regard to payments to optometrists and ophthalmologists. Payments to optometrists increased from $12 million in 1986, a year before the Medicare Amendment to $81 million in 1988, the first full year after the law's implementation increasing their market share of Medicare payments from 2.6% to 11.1%. Ophthalmology incurred a significant decrease in market share from 97.9% to 88.9% during this period.

Direct Service Costs↗
PubMed1990

A survey of optometric practice in New York State: trends and policy considerations.

A mail survey of actively practicing optometrists in New York state revealed information about present and future manpower supply, modes of practice, procedures and instrumentation used, services rendered, third party reimbursement and involvement in continuing education. The survey illustrates the need to increase the gathering of such data in order to analyze practice patterns and more accurately initiate short- and long-term planning within the profession.

Adult↗
PubMed1990

Comprehensive vision care under third party programs: increased services and increased scrutiny.

Physician reimbursement under Medicare has been rising by about 15 percent each year. Part of this increase is due to an increase in unnecessary tests and procedures. To control provider billing, Congress passed legislation that will establish a Medicare fees schedule and expenditure targets. Increased surveillance and monitoring of Medicare claims are taking place. Diagnostic procedures are being questioned and denied when deemed inappropriate in relation to a diagnosis. Managed care techniques also are being implemented by private insurance carriers to prevent overutilization. Clinic practice guidelines are being developed by the health professions. Optometry, as well as all other health professions, will be subject to increased utilization and quality review.

Delivery of Health Care↗
PubMed1989

Vision care benefits and optometric services in HMOs.

General eye care, although not a required basic health service of federally qualified health maintenance organizations (HMOs), is being offered in virtually all HMOs. Reasons for including vision care benefits and optometric services are presented. Data from the Group Health Association of America and the Department of Health and Human Services demonstrates that HMOs are in fact providing vision care benefits and optometric services. The growth of the independent practice association (IPA) model is significant for optometry as it threatens to limit the scope of optometric practice. New professional problems arise as participating optometrists are constrained from performing the full range of optometric services. In recent years optometry has expanded its scope of licensure and practice to incorporate both diagnostic and therapeutic drugs in its management of visual problems. Managed care and alternate delivery systems, however, may restrict the advances that optometry has made in the legislative arena.

Health Maintenance Organizations↗
PubMed1986

Vision care and health insurance coverage.

This paper presents an overview of third party coverage for optometric services. A questionnaire survey of insurance companies was conducted to determine the extent of major medical coverage for specific optometric services. The influence of freedom of choice laws, expanded scope, pharmaceutical agent legislation and the Medicare program is discussed. The proper use of accepted diagnostic and procedural codes is underscored.

Aphakia↗
PubMed1983

Vision care policy, ophthalmological practices and the Medicare program.

Medicare specifically excludes routine eye examinations and refractive services. In optometric circles, it is widely believed that ophthalmologists are currently receiving payment for routine eye care and refractive services. A survey of ophthalmologists and optometrists in New York State is presented with respect to their fees and participation in the Medicare program. The use of procedures and diagnosis codes and its impact on billing practices by ophthalmologists is reviewed. Data from a Medicare intermediary and from a provider of health care services raise serious issues regarding Medicare's policy of excluding routine eye care. A review of existing rules and regulations and its implementation appears in order.

Eye Diseases↗