Each year, barring very bad economic times, the average worker usually gets a cost-of-living increase to offset inflation. In fact, this year, the Federal Register published that a cost-of-living increase of about 3.2 percent would be instituted by the Social Security Administration, based on the past year’s Consumer Price Index.1 

Ironically, it was also announced in the Federal Register that the government is slashing Medicare reimbursement rates by 5.4 percent. It’s odd how the powers-that-be acknowledge people need an increase to offset the rising cost of living, while, at the same time, inform ophthalmologists and other physicians they deserve to take a cut. Ambulatory surgical centers, however, got a 2.8-percent increase to their reimbursement rates, as long as they met certain quality criteria in the past year.

This last part is kind of a head-scratcher because, yes, ASCs have overhead, but don’t ophthalmologists have costs to worry about, too? According to a poll by the Medical Group Management Association, 96 percent of medical groups experienced either an increase in their operating costs or saw their costs stay the same in the past year.2 The average increase in costs cited by the poll’s respondents was 12.5 percent, owed mostly to increases in wages and salaries, higher supply costs and information technology expenses.2 In the face of this, a cut of just more than 5 percent is a bitter pill to swallow, especially when cataract surgery is such an integral part of most ophthalmologists’ practices. Where’s their cost-of-living increase?

Against this backdrop of rising costs due to inflation and cuts to reimbursement, this month’s cover story on mixing and matching intraocular lenses (pg. 33) takes on added significance. This is because most of the lenses discussed by surgeons in the article are in the premium category, so implanting them would help offset any of the losses imposed by the impending cuts to Medicare reimbursement. 

In the past, surgeons have consistently demonstrated a hesitancy to jump into the world of premium IOL implantation, and for good reason—it involves a good deal of expense in terms of education, staff training and new equipment (including purchasing the lenses). However, as the new year dawns, and considering the current Medicare cut and the potential for future cuts to come, it might be time for surgeons to start mixing and matching a Medicare practice with a fee-for-service one.

Whichever path you choose this year, the staff of Review wishes you all a heathy, successful 2024.




— Walter Bethke
Editor in Chief


1. The Federal Register. https://www.federalregister.gov/documents/2023/10/23/2023-23317/cost-of-living-increase-and-other-determinations-for-2024#:~:text=The%20CPI%20for%20the%20calendar,title%20II%20of%20the%20Act. Accessed December 21, 2023.

2. Harrop C. Higher costs for medical groups persist even as inflation growth slows. https://www.mgma.com/mgma-stat/higher-costs-persist-for-medical-groups-even-as-inflations-growth-slows. Accessed December 21, 2023.