PURPOSE To estimate the financial impact of COVID-19-related shutdowns on ophthalmic surgery performed at hospital outpatient departments (HOPDs) in the United States .
SETTING Nationally representative sample of U.S. hospital payment and cost data .
DESIGN Retrospective review and economic impact analysis .
METHODS The Nationwide Ambulatory Surgery Sample (NASS) was used to identify ophthalmic surgical procedures and associated charges that were performed at HOPDs . The highest volume elective ophthalmic procedures were identified . The total hospital cost and payment amount was calculated for each procedure using the Hospital Outpatient Prospective Payment System (OPPS) maintained by the Centers for Medicare & Medicaid Services . Net facility income (estimated payments less OPPS rates) was determined for each elective surgical procedure category and also stratified by hospital teaching status .
RESULTS In 2017, elective cataract, strabismus, and keratoplasty surgeries were performed 1,230,992 times at HOPDs . The total cost of these elective surgeries was 2,350 million USD, with a total hospital payment of 3,624-3,786 million USD . This led to an estimated net income of 1,278-1,440 million USD overall to U.S. hospitals in the NASS dataset from elective ophthalmic surgery (approximately 107-120 million USD per month), with a larger proportion performed in teaching hospitals .
CONCLUSIONS The cessation of elective ophthalmic surgeries at HOPDs during COVID-19 resulted in a significant loss of income for hospitals in the U.S. as well as teaching experiences for trainees at academic medical centers.