Dr. Mort Soroka has published numerous studies in the realm of eye care. Of those publications, nine of them stand out as pivotal pieces that shed new insight and understanding of the American eye care market.

• "Optometric and ophthalmological eye care under the Medicare program"
• "Vision care policy, ophthalmological practices and the Medicare program"
• "A comparison of charges by optometrists and ophthalmologists under the Medicare program"
• "The Medicare Optometry Parity Amendment: predicted and actual payments to optometrists and ophthalmologists".
• "Comparison of Examination Fees and Availability of Routine Vision Care by Optometrists and Ophthalmologists"
• "Specialty differentials, limited license practioners, and Medicare's new few schedule"
• "Optimal clinical management of eye problems: the role of optometrist in managed care plans"
• "Eye Care Providers in Managed Care"
• "Optometry and Ophthalmology: the Internet connection ö assessing consumer health Web sites"

Dr. Soroka's initial interest in the elderly population and eye care service use is exemplified in his 1980 study, "Optometric and ophthalmological eye care under the Medicare program". This study surveyed the elderly within the New York City area, to determine eye care service use, with an emphasis on who was providing services and the source of payment. The study revealed that significant differences in payment methodology existed between patients seen by an optometrist versus those seen by an ophthalmologist. The key finding of this study was that Medicare payments to ophthalmologists were not based on actual or suspected eye pathology. This was contrary to Medicare reimbursement policy. This insight had a great impact both on the eye care market and the Medicare policy arena.

Dr. Soroka's 1983 study, "Vision care policy, ophthalmological practices and the Medicare program" further explored issues of inequity in terms of reimbursement for routine eye care and refractive services provided by optometrists and ophthalmologists. Issues arise due to the fact that Medicare does not explicitly cover routine eye care and refractive services, yet it has been demonstrated that ophthalmologists who provided both routine and specialized services, are in fact reimbursed for eye care examinations and refractive services. However, an optometrist providing routine care is not eligible for Medicare billing. This great discrepancy is the centerpiece of conflict between professions in attempting to rectify a biased reimbursement system.

Dr. Soroka's 1991 study, "A comparison of charges by optometrists and ophthalmologists under the Medicare program" utilized Medicare Part B claims, to demonstrate that optometric charges are considerably lower than ophthalmological charges for all services that were compared. Cost differentials between optometrists and ophthalmologist were significant. As for the most frequently performed services, fee differentials ranged from 7-42 percent. At the time of the study, provider dependent reimbursement levels were a prioritized issue under the review of the Physician Payment Review Commission. The study stated that in order for optometrists to be reimbursed at the same level as ophthalmologists they need to show that the procedure codes that they utilize are comparable and identical in service content.

In wake of the Omnibus and Reconciliation Act (OBRA) legislation, Dr. Soroka's 1991 study "The Medicare Optometry Parity Amendment: predicted and actual payments to optometrists and ophthalmologists" compared various cost projections for the expansion of optometric services under Medicare that were developed prior to the 1986 amendment. Under the enactment, Medicare recognizes optometrists as physicians in terms of the services they provided in respect to state law or authorization. This law redefined the conditions of optometric participation and expanded coverage to include all Medicare covered services. The study found that reimbursement to optometrists increased from 2.6 to 11% after one year of the law's enactment. This study only had the ability to define the effects of legislation on market share for a one year period. While our proposed study has a multitude of research vantage points, we are examining legislative effects on payment reimbursement. Our proposed research further follows up on this study.

Dr Soroka addresses issues of the cost effectiveness of utilizing optometrists over ophthalmologists in the delivery of routine eye care services, in his 1991 study "Comparison of Examination Fees and Availability of Routine Vision Care by Optometrists and Ophthalmologists". The study found that the average examination fees and waiting times for appointments was considerably lower for optometrists than for ophthalmologists. From this finding, it may be inferred that cost benefits would arise for both the patient and the overall health sector if patients are examined by an optometrist instead of an ophthalmologist, for services that may be rendered by either specialty.

Dr. Soroka's 1992 publication "Specialty differentials, limited license practitioners, and Medicare's new fee schedule" explores the issues of specialty differentials within the Medicare fee schedule. The discussion views the Physician Payment Review Commission's recommendations for eliminating specialty differentials as a means for optometrists to gain parity in the area of Medicare covered services. The questions explored in this publication form a framework that we have referenced in developing our current proposal in terms of the goals and objectives we wish to reach.

Dr. Soroka's 2000 study, "Optimal clinical management of eye problems: the role of optometrists in managed care plans" explored the role of the optometrist within a managed care plan. The study determined that optometrists provide a range of eye care, and the care delivered is affected by the legal scope of the optometrist's practice licensure in addition to the actual financial and organizational factors found within the managed care organization. Our proposed research has the intention of viewing the range of scope of an optometrist's services within a Medicare population, and while the settings differ between studies, one may anticipate that results may be similar. Reasons for variances are of our interest and present themselves as areas for future investigation.

An additional study conducted by Dr. Soroka, "Eye Care Providers in Managed Care" explored the roles of ophthalmologists, optometrists, and opticians within a managed care delivery system. This article asserted that the increase in optometrists being the primary provider of eye care within a managed care setting is due in part to both the expansion of optometric licensure and cost incentives within the managed care organization. This paper also explores issues of comanagement models in order to develop a prospective vertically integrated eye health care system that not only maximizes quality but also minimizes over all costs associated with service delivery.

In addition to exploring issues of managed care and Medicare legislation in relation to eye care, Dr. Soroka has focused efforts towards looking at information technology and how it relates to eye care in terms of breadth of information, in addition to accuracy and reliability. These efforts were realized through Dr. Soroka's 2001 study, "Optometry and Ophthalmology: the Internet connection ö assessing consumer health web sites". His study indicated that information regarding the roles and practices of optometrists are often false or outdated. This study is highly demonstrative that information disseminated by health organizations may not be accurate and optometry's role is often misrepresented. This study serves as the basis for taking on an initiative to rectify and update misleading and outdated information contained within consumer health sites, serving to benefit both the prospective patient and existing provider networks.

These studies demonstrate that the primary investigator has extensive experience in collecting and analyzing data in the area of public policy and eye care, in addition the findings of past studies lead up to the prospective research aims of our proposed study.