Manchikanti Laxmaiah, Pampati Vidyasagar, Sanapati Mahendra R, Nampiaparampil Devi E, Knezevic Nebojsa Nick, Kaye Alan D, Soin Amol, Gharibo Christopher G, Abd-Elsayed Alaa, Hirsch Joshua A
Pain Management Centers of America, Paducah, KY and Evansville, IN; Departments of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY; LSU Health Science Center, New Orleans, LA.
Pain Management Centers of America, Paducah, KY.
Pain Physician. 2024 Nov;27(8):455-467.
Numerous studies have highlighted the escalating costs associated with managing low back and neck pain, as well as other musculoskeletal disorders. In the past, there was a notable increase in the use of interventional techniques to address these disorders. However, the COVID-19 pandemic disrupted various chronic pain treatment approaches, including interventional procedures and opioid use, following a broader trend of reduced healthcare services. Consequently, there was an 18.7% decline in the use of interventional techniques per 100,000 Medicare beneficiaries between 2019 and 2020, a stark contrast to the previous growth patterns, despite some initial declines observed starting in 2017.
This analysis aims to provide an updated evaluation of the utilization of interventional techniques for chronic pain management in the U.S. Medicare population.
A retrospective cohort study examining utilization patterns and factors affecting interventional techniques for chronic pain management in the FFS Medicare population in the United States from 2000 to 2022.
Data for this analysis was obtained from the Centers for Medicare & Medicaid Services (CMS) master database, specifically the physician/supplier procedure summary, spanning the years 2000 to 2022.
This retrospective cohort study found that the rate of interventional pain management services per 100,000 Medicare beneficiaries showed a cumulative decline between 2019 and 2022 of 28.9%, with an annual decrease of 10.7%. This contrasts sharply with the 2010-2019 period, which saw a small annual decline of 0.4%. Particularly significant was the sharp reduction of 18.7% from 2019 to 2020, coinciding with the pandemic. From 2020 to 2021, the decline slowed to 1.1%, before accelerating again with an 11.5% drop between 2021 and 2022.
Data were available only through 2022 and were limited to the FFS Medicare population; utilization patterns for Medicare Advantage Plans, which accounted for nearly 50% of Medicare enrollment in 2022, were not included. Additionally, this analysis shares the inherent limitations of all retrospective reviews based on claims data.
This retrospective analysis demonstrates a significant reduction in the use of interventional pain management techniques from 2019 to 2022. Contributing factors to this decline likely include the lasting effects of COVID-19, economic challenges, the Affordable Care Act (ACA), and evolving local coverage determination policies.
众多研究强调了管理腰背痛、颈痛以及其他肌肉骨骼疾病的成本不断攀升。过去，用于治疗这些疾病的介入技术使用量显著增加。然而，新冠疫情打乱了各种慢性疼痛治疗方法，包括介入手术和阿片类药物的使用，这顺应了医疗服务减少的总体趋势。因此，2019年至2020年期间，每10万名医疗保险受益人中，介入技术的使用量下降了18.7%，这与之前的增长模式形成鲜明对比，尽管从2017年开始就出现了一些初步下降。
本分析旨在对美国医疗保险人群中用于慢性疼痛管理的介入技术使用情况进行最新评估。
一项回顾性队列研究，考察2000年至2022年美国联邦医疗保险（FFS Medicare）人群中慢性疼痛管理介入技术的使用模式及影响因素。
本分析的数据来自医疗保险和医疗补助服务中心（CMS）的主数据库，具体为2000年至2022年期间的医生/供应商手术摘要。
这项回顾性队列研究发现，2019年至2022年期间，每10万名医疗保险受益人中，介入性疼痛管理服务的使用率累计下降了28.9%，年降幅为10.7%。这与2010年至2019年期间形成鲜明对比，当时年降幅仅为0.4%。特别显著的是，2019年至2020年期间急剧下降了18.7%，与疫情期间相吻合。2020年至2021年，降幅放缓至1.1%，之后在2021年至2022年期间再次加速下降，降幅为11.5%。
数据仅涵盖至2022年，且仅限于联邦医疗保险人群；未包括2022年占医疗保险参保人数近50%的医疗保险优势计划的使用模式。此外，本分析存在所有基于索赔数据的回顾性评估所固有的局限性。
这项回顾性分析表明，2019年至2022年期间，介入性疼痛管理技术的使用量显著减少。导致这种下降的因素可能包括新冠疫情的长期影响、经济挑战、《平价医疗法案》（ACA）以及不断演变的地方医保覆盖范围确定政策。
