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. 2023 Sep 1;152(3):e2023062114.
doi: 10.1542/peds.2023-062114.

Vision Screening Among Children With Private Insurance: 2010-2019

Isdin Oke  1   2 , Sharon M Lutz  2 , David G Hunter  1 , Alison A Galbraith  3
Affiliations

Vision Screening Among Children With Private Insurance: 2010-2019

Isdin Oke et al. Pediatrics. .

Abstract

Objectives: To describe trends in vision screening based on insurance claims for young children in the United States.

Methods: This cross-sectional study used administrative claims data from the 2010-2019 IBM MarketScan Commercial Claims and Encounters Database. We included children aged 1 to <5 years at the beginning of each calendar year. The primary outcome was a vision screening claim within 12 months for chart-based or instrument-based screening. Linear regression was used to evaluate trends over time in vision screening claims and practitioner payment.

Results: This study included a median of 810 048 (interquartile range, 631 523 - 1 029 481) children between 2010 and 2019 (mean [standard deviation] age, 2.5 [1.1] years; 48.7% female). The percentage of children with vision screening claims increased from 16.7% in 2010 to 44.3% in 2019 (difference, 27.5%; 95% confidence interval, 27.4% to 27.7%). Instrument-based screening claims, which were identified in <0.2% of children in 2010, increased to 23.4% of children 1 to <3 years old and 14.4% of children 3 to <5 years old by 2019. From 2013 to 2018, the average of the median practitioner payment for instrument-based screening was $23.70, decreasing $2.10 per year during this time (95% confidence interval, $0.85 to $3.34; P = .009).

Conclusions: Vision screening claims among young children nearly tripled over the last decade, and this change was driven by increased instrument-based screening for children aged <3 years. Further investigation is needed to determine whether the decreasing trends in practitioner payment for screening devices will reduce the adoption of vision screening technology in clinical practice.

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Conflict of interest statement

Conflicts of Interest Disclosures: David G. Hunter reports involvement with Rebion, Inc (founder, equity) and Luminopia, Inc (advisor, equity). The remaining authors have indicated they have no conflicts of interest relevant to this article to disclose.

Figures

Figure 1:
Figure 1:
Instrument-based vision screening claims of commercially insured children (aged 1 to 5 years) between 2010 and 2019 in the US.
Figure 2:
Figure 2:
A) The percentage of vision screening claims without seperate, unbundled practitioner payment and B) The median practitioner payment per vision screening claim in 2018 US dollars. Payment data were not available for the 2019 calendar year.
See this image and copyright information in PMC

Comment in

References

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