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    Glaucoma ‘tsunami’ bearing down on how EyeMDs will practice medicine


    But predictions about the aging of the U.S. population are on a solid foundation, Dr Mattox added. Notably, by 2025 the population over 65 is set to surge 46%. The number of glaucoma cases should increase proportionately, which translates to about 4.3 million new patients, said Dr. Mattox, citing Prevent Blindness America data.

    The age group that will have the most glaucoma is ages 70-79, she said. “That continues to trend forward into the even more aged groups as we move further into the future.”

    More Glaucoma 360: How success in glaucoma innovation must come from within

    The ethnic composition of the population with glaucoma is changing as well, with African Americans holding steady at 20%. Hispanic numbers are growing and expected to reach the same proportion by 2050, Dr. Mattox said.

    Payment implications

    These shifts have implications for payment policy, said Dr. Mattox. She cited a Medicare Trustees report in June 2015 that counted 53.8 million beneficiaries. Most of them are in the 65 years or older group.

    Related: Evidence-based answers to nutrition and exercise questions on glaucoma

    Of these, about 30% subscribe to the Medicare Advantage plans. “What’s really interesting to me is that of new enrollees, all those Baby Boomers, over two thirds of them are choosing to be in a Medicare Advantage plan,” Dr. Mattox said. “That has implications for payment and rules about how you get paid in the future.”

    Medicare spent $613.3 billion in 2014, and what is concerning in this report is the projection by the Medicare Trustees that Part B physician services over the next five years will increase 6.7% year over year and Part D drug expenditures will increase almost 11% year over year.

    Meanwhile, overall U.S. health expenditures are projected to increase an average of 5.8% annually over the next 10 years. “That’s after some historic lows over the past few years,” said Dr. Mattox. “Now, they’re expecting it to trend upward again.”

    More: Glaucoma 360 inspires philanthropy, industry, CME

    By 2024, the United States will spend 19.6% of its gross domestic product (GDP) on healthcare, she said.

    “Are we scared yet?” she asked. “So this is what we are facing, and a lot of work has to get done in order for us to manage how we’re going to take care of our patients.”

    If you’re in the path of a tsunami, you can react two ways, she said. You can flee to high ground, or you can “grab your surf board and go surf the wave.”

    Hard look

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