The time and financial ramifications of providing services for retinopathy of prematurity at a single inner-city institution in the United States: a pilot study

Vivian S. Hawn, Rakin Muhtadi, Jason Oliviera, Pamela Suman, Graham Quinn, Umar Mian

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Retinopathy of prematurity (ROP) is a sight-threatening disease that requires strict, scheduled screening and timely treatment. Examining infants in the neonatal intensive care unit (NICU) confers an added burden for ophthalmologists whose practices are predominantly outpatient. We sought to evaluate the time required for ROP services and to approximate compensation to better understand the implications of providing this crucial service. Methods: The ROP coordinator tracked the time ophthalmologists spent providing ROP services at two NICUs (2018-2020). Estimated revenue was calculated using Medicaid Current Procedural Terminology codes. Total ophthalmologist time was from NICU arrival to departure; travel time was estimated as 45 minutes. Results: The ophthalmologists cumulatively spent on average 98 and 108 hours yearly for screening only (SO) and screening plus treatment (ST), respectively; this increased to 164 and 181 hours yearly with travel time, respectively. Estimated annual Medicaid physician reimbursements were $15,246 ($156/hour) for SO and $19,184 for ST ($177/hour). Actual annual physician reimbursements were $39,655 ($405/hour) for SO and $53,385 for ST ($492/hour). With travel time, reimbursements decreased by about 40%. A hypothetical full-time ROP practice would generate annual physician salaries of $204,732 for SO and $232,807 for ST. With travel time, this decreases to $122,452 and $139,379, respectively. Conclusions: Performing ROP services requires substantial time, especially when including travel among facilities. This study highlights the extensive requirements for the critical task of decreasing ROP blindness.

Original languageEnglish (US)
Pages (from-to)135.e1-135.e4
JournalJournal of AAPOS
Volume26
Issue number3
DOIs
StatePublished - Jun 2022

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Ophthalmology

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