Background: Diabetic retinopathy is the leading cause of incident blindness among working age U.S. adults. Only slightly more than half of Medicare beneficiaries with diabetes receive an annual eye exam, and this rate is lower among Hispanic and black beneficiaries compared to white beneficiaries.

Objective: We examine racial/ethnic differences in diabetes-related eye disease and treatment claims, among Medicare beneficiaries with diabetes.

Methods: We analyzed 2017 Medicare claims for 8,341,000 beneficiaries (both ≥65 years and <65 years with disabilities) with diagnosed diabetes who were continuously enrolled during 2017 in Part B fee-for-service (FFS) insurance. Diagnoses for diabetes and diabetes-related eye diseases were defined using ICD-10-CM diagnosis codes and treatments were classified using procedure codes in the claims. We present crude national percentages.

Results: In 2017, 28% of FFS beneficiaries had diabetes. Of these, 9.6% had a claim for any diabetes-related eye disease; this annual rate was higher among Hispanic (13.1%), non-Hispanic black (11.2%), and Asian/Pacific Islander (11.4%) beneficiaries than among white beneficiaries (8.7%). Early/mild diabetic retinopathy was the most prevalent form (6.3%) and diabetic macular edema was the least prevalent (0.6%). Of beneficiaries with diabetes-related eye disease, 15.2% had at least one type of treatment; treatment types received were anti-vascular endothelial growth factor injections (11.8%), laser photocoagulation (4.7%), vitrectomy (1.3%), and retinal detachment repair (0.7%). Annual prevalence of any treatment was higher among Hispanic (19.0%) and non-Hispanic black (15.5%) beneficiaries compared to white beneficiaries (14.7%); it was lowest among Asian/Pacific Islander beneficiaries (12.9%).

Conclusions: Annually, around one-in-ten Medicare Part B FFS beneficiaries with diabetes has a claim for diabetes-related eye disease, and this rate is higher among Hispanic and black beneficiaries.


E.A. Lundeen: None. D.B. Rein: None. J. Wittenborn: None. J.B. Saaddine: None.

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