2016 VSP Summary Data Report For the Vision Eye health Surveillance System DATE PRESENTED TO PRESENTED BY JUNE20,2018 Jinan Saaddine John Wittenborn Division of diabetes translation NORC at the University of Chicago Centers for Disease Control and Prevention Phillip Kimura Mary Beth Richardson VSP Global Vision NORC &E EYE HEALTH H: SS SURVEILLANCE at the UNIVERSITYof CHICAgo SYSTEMI
2016 VSP Summary Data Report For the Vision & Eye Health Surveillance System DATE JUNE 20, 2018 PRESENTED TO: Jinan Saaddine, Division of Diabetes Translation, Centers for Disease Control and Prevention PRESENTED BY: John Wittenborn, NORC at the University of Chicago Phillip Kimura, MaryBeth Richardson, VSP Global
NORC I 2016 VSP Summary Data Report for the Vision& Eye Health Surveillance System Table of contents Dataset Description Analysis Overview 5 Data Indicators and Case definitions Service utilization- Eye EXams..….… 6 Medical Di 8 Denominators used to calculate Prevalence rates Stratification Facto Age Groups Sex Categories Race/ethnicity Categories States and Territories Suppression and Data Release Restrictions Potential limitations Service Utilization Indicators(Number of patients receiving service per 100 patients).15 Medical Diagnosis Indicators(Number of patients with diagnosis per 100 patients)
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System | II Table of Contents Dataset Description ..................................................................................................................5 Analysis Overview ....................................................................................................................5 Data Indicators and Case Definitions ..................................................................................6 Service Utilization-Eye Exams ...................................................................................6 Medical Diagnoses ....................................................................................................8 Denominators used to Calculate Prevalence Rates ..........................................................11 Stratification Factors .........................................................................................................12 Age Groups .............................................................................................................12 Sex Categories ........................................................................................................12 Race/ethnicity Categories........................................................................................12 States and Territories ..............................................................................................12 Suppression and Data Release Restrictions .....................................................................13 Potential Limitations...............................................................................................................14 Service Utilization Indicators (Number of patients receiving service per 100 patients) ....15 Medical Diagnosis Indicators (Number of patients with diagnosis per 100 patients) ........18
NORC I 2016 VSP Summary Data Report for the Vision& Eye Health Surveillance System List of Tables Table 1. Service Utilization Topic Indicators Table 2. Procedure codes included in Exams Table 3. 2013 Eye Care Provider Categories Taxonomy Codes Table 4. Medical Diagnosis Categories and Subgroups Table 5. VEHSS State and Territory Abbreviations Table 7. Exam rate by Age Group, 201 0356 Table 8. Exam rate by Sex, 2016 Tabe9. EXam rate by State,2016…… Table 10. Treated Prevalence of Medical Diagnoses by Category and Subgroup, 2016......18 Table 11. Medical Diagnosis Categories by Age Group, 2016 Table 12. Medical Diagnosis Categories by Sex, 2016 Table 13. Medical Diagnosis Categories by State, 2016, Age related macular degeneration Table 14. Medical Diagnosis Categories by State, 2016, Blindness and low vision Table 15. Medical Diagnosis Categories by State, 2016, Cancer and neoplasms of the eye diseases Table 16. Medical Diagnosis Categories by State, 2016, Cataracts Table 17. Medical Diagnosis Categories by State, 2016, Cornea disorders 27 Table 18. Medical Diagnosis Categories by State, 2016, Diabetic eye diseases Table 19. Medical Diagnosis Categories by State, 2016, Disorders of optic nerve and visual pathways Table 20. Medical Diagnosis Categories by State, 2016, Refraction and accommodation Table 21. Medical Diagnosis Categories by State, 2016, Glaucoma Table 22. Medical Diagnosis Categories by State, 2016, Infectious and inflammatory diseases Table 23. Medical Diagnosis Categories by State, 2016, Injury, burns and surgical complications of the eye Table 24. Medical Diagnosis Categories by State, 2016, Orbital and external disease diseases Table 25. Medical Diagnosis Categories by State, 2016, Other retinal disorders
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System | III List of Tables Table 1. Service Utilization Topic Indicators .........................................................................6 Table 2. Procedure Codes Included in Exams ......................................................................7 Table 3. 2013 Eye Care Provider Categories Taxonomy Codes ...........................................8 Table 4. Medical Diagnosis Categories and Subgroups......................................................10 Table 5. VEHSS State and Territory Abbreviations.............................................................13 Table 7. Exam rate by Age Group, 2016.............................................................................15 Table 8. Exam rate by Sex, 2016........................................................................................16 Table 9. Exam rate by State, 2016 .....................................................................................17 Table 10. Treated Prevalence of Medical Diagnoses by Category and Subgroup, 2016.......18 Table 11. Medical Diagnosis Categories by Age Group, 2016 ..............................................21 Table 12. Medical Diagnosis Categories by Sex, 2016 .........................................................22 Table 13. Medical Diagnosis Categories by State, 2016, Age related macular degeneration.......................................................................................................23 Table 14. Medical Diagnosis Categories by State, 2016, Blindness and low vision...........24 Table 15. Medical Diagnosis Categories by State, 2016, Cancer and neoplasms of the eye diseases .......................................................................................................25 Table 16. Medical Diagnosis Categories by State, 2016, Cataracts.....................................26 Table 17. Medical Diagnosis Categories by State, 2016, Cornea disorders........................27 Table 18. Medical Diagnosis Categories by State, 2016, Diabetic eye diseases ................28 Table 19. Medical Diagnosis Categories by State, 2016, Disorders of optic nerve and visual pathways ..................................................................................................29 Table 20. Medical Diagnosis Categories by State, 2016, Refraction and accommodation ..................................................................................................30 Table 21. Medical Diagnosis Categories by State, 2016, Glaucoma....................................31 Table 22. Medical Diagnosis Categories by State, 2016, Infectious and inflammatory diseases ..............................................................................................................32 Table 23. Medical Diagnosis Categories by State, 2016, Injury, burns and surgical complications of the eye....................................................................................33 Table 24. Medical Diagnosis Categories by State, 2016, Orbital and external disease diseases ..............................................................................................................34 Table 25. Medical Diagnosis Categories by State, 2016, Other retinal disorders...............35
NORC I 2016 VSP Summary Data Report for the Vision& Eye Health Surveillance System Table 26. Medical Diagnosis Categories by State, 2016, Other eye disorders Table 27. Medical Diagnosis Categories by State, 2016, Other visual disturbances Table 28. Medical Diagnosis Categories by State, 2016, Retinal detachment and defects Table 29. Medical Diagnosis Categories by State, 2016, Strabismus and amblyopia ......39 N
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System | IV Table 26. Medical Diagnosis Categories by State, 2016, Other eye disorders....................36 Table 27. Medical Diagnosis Categories by State, 2016, Other visual disturbances..........37 Table 28. Medical Diagnosis Categories by State, 2016, Retinal detachment and defects.................................................................................................................38 Table 29. Medical Diagnosis Categories by State, 2016, Strabismus and amblyopia ........39
NORC I 2016 VSP Summary Data Report for the vision& Eye Health Surveillance System Dataset Description VSP Global is the nations largest vision insurance provider, operating as a nonprofit corporation for 60 years. Vision insurance is a specialized supplemental insurance provided through employers, commercial health plans, Medicare/Medicaid supplement plans, the federal employees health benefits program (FEHB), tribes, or purchased individually to provide routine vision care coverage. Generally, VSP data includes optometric exams and procedures, diagnoses(refractive errors, eye disease, systemic disease, acute issues), vision correction utilization, prescriptions and materials dispensed, costs, provider information, and patient demographics VSP does not report their patient volume but report that more than one in four Americans have VSP coverage. VSP processes claims in every state, but market penetration varies by state. VSP's national network contains about 33,000 eye care professionals. Approximately 85% are OD,'s(optometrist), and 15% are MD's(ophthalmologist) vSP claims contain the age of patients, but do not include race/ethnicity. Medical diagnosis coverage in VSP claims are Vision insurance claims typically include diagnosis codes for refractive error, but medical diagnoses are generally not required for payment of routine vision services thus their inclusion in claims by the billing practice is optional. This is especially true for non-refraction related codes. Diagnosis information in VSP claims cannot be considered as disease prevalence estimates but could be considered an indicator of vision care services Analysis Overview For the vess project, VSP analyzed their 2016 claims databases to estimate the annual prevalence rate of treated diagnoses and the rate of clinical procedures. VSP analyzed the claims data and provided NORC with de-identified summary reports of frequencies and rates, summarized by state and by age group, race/ethnicity, and sex NORC further analyzed the summary data files, mapping outcomes to VEHSS-defined categories calculating confidence intervals, cleaning data. Results were further suppressed if the numerator was <3 and the denominator was less than 30. or the numerator was >3 and the denominator was <30 NORC found that about 8%of VSP patients who had no claims filed during the year did not have a state of residence identified. State of residence for these patients was imputed based on the state-distribution of beneficiaries with a state location on file. VSP stated that they did not believe that there were any systematic reasons why the inclusion of beneficiary's address information would vary by state, and thus
NORC | 2016 VSP Summary Data Report for the Vision & Eye Health Surveillance System 5 Dataset Description VSP Global is the nation’s largest vision insurance provider, operating as a nonprofit corporation for 60 years. Vision insurance is a specialized supplemental insurance provided through employers, commercial health plans, Medicare/Medicaid supplement plans, the federal employees health benefits program (FEHB), tribes, or purchased individually to provide routine vision care coverage. Generally, VSP data includes optometric exams and procedures, diagnoses (refractive errors, eye disease, systemic disease, acute issues), vision correction utilization, prescriptions and materials dispensed, costs, provider information, and patient demographics. VSP does not report their patient volume, but report that more than one in four Americans have VSP coverage. VSP processes claims in every state, but market penetration varies by state. VSP’s national network contains about 33,000 eye care professionals. Approximately 85% are OD’s (optometrist), and 15% are MD’s (ophthalmologist). VSP claims contain the age and sex of patients, but do not include race/ethnicity. Medical diagnosis coverage in VSP claims are limited. Vision insurance claims typically include diagnosis codes for refractive error, but medical diagnoses are generally not required for payment of routine vision services, thus their inclusion in claims by the billing practice is optional. This is especially true for non-refraction related codes. Diagnosis information in VSP claims cannot be considered as disease prevalence estimates, but could be considered an indicator of vision care services. Analysis Overview For the VEHSS project, VSP analyzed their 2016 claims databases to estimate the annual prevalence rate of treated diagnoses and the rate of clinical procedures. VSP analyzed the claims data and provided NORC with de-identified summary reports of frequencies and rates, summarized by state and by age group, race/ethnicity, and sex. NORC further analyzed the summary data files, mapping outcomes to VEHSS-defined categories, calculating confidence intervals, cleaning data. Results were further suppressed if the numerator was <3 and the denominator was less than 30, or the numerator was ≥3 and the denominator was ≤30. NORC found that about 8% of VSP patients who had no claims filed during the year did not have a state of residence identified. State of residence for these patients was imputed based on the state-distribution of beneficiaries with a state location on file. VSP stated that they did not believe that there were any systematic reasons why the inclusion of beneficiary’s address information would vary by state, and thus