Patients seen at private facilities reimbursed by Medicare were more than 550 percent more likely to have routine cataract surgery than those who received their care from the Department of Veterans Affairs, a strong indication that the frequency of cataract surgery may be responsive to financial incentives to either or both the medical facility and the physicians who perform the procedure.These findings from a large eight-year study are reported in the March 2010 issue of the American Journal of Medical Quality.The authors are uncertain of the cause of the disparity in cataract surgery given that the vast majority of older veterans are enrolled in both Medicare and the VA health system, both government-funded systems."We don't know yet what exactly accounts for the five and a half fold difference in surgery rates between the two systems.