Trends of Expenditures and Utilization of Facet Joint Interventions in Fee-For-Service (FFS) Medicare Population from 2009-2018
Background: The trends of the expenditures of facet joint interventions have not been specifically assessed in the fee-for-service (FFS) Medicare population since 2009 Objectives: The objective of this investigation is to assess trends of expenditures and utilization of facet joint interventions in...
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Veröffentlicht in: | Pain physician 2020-05, Vol.23 (3S), p.S129-S147 |
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Zusammenfassung: | Background: The trends of the expenditures of facet joint interventions have not been
specifically assessed in the fee-for-service (FFS) Medicare population since 2009
Objectives: The objective of this investigation is to assess trends of expenditures and
utilization of facet joint interventions in FFS Medicare population from 2009 to 2018.
Study Design: The study was designed to analyze trends of expenditures and utilization of
facet joint interventions in FFS Medicare population from 2009-2018 in the United States. In
this manuscript:
• A patient was considered as undergoing facet joint interventions throughout the year.
• A visit included all regions treated during the visit.
• An episode was considered as one per region utilizing primary codes only.
• Services or procedures were considered all procedures (multiple levels).
Data for the analysis was obtained from the standard 5% national sample of the Centers
for Medicare & Medicaid Services (CMS) physician outpatient billing claims for those enrolled
in the FFS Medicare program from 2009 to 2018. All the expenditures were presented with
allowed costs and also were inflation adjusted to 2018 US dollars.
Results: This analysis showed expenditures increased by 79% from 2009 to 2018 in the
form of total cost for facet joint interventions, at an annual rate of 6.7%. Cervical and lumbar
radiofrequency neurotomy procedures increased 185% and 169%. However, inflation-adjusted
expenditures with 2018 US dollars showed an overall increase of 53% with an annual increase of
4.9%. In addition, using inflation-adjusted expenditures per procedures increased, the overall 6%
with an annual increase of 0.7%. Overall, per patient costs, with inflation adjustment, decreased
from $1,925 to $1,785 with a decline of 7% and an annual decline of 0.8%. Allowed charges
per visit also declined after inflation adjustment from $951.76 to $849.86 with an overall decline
of 11% and an annual decline of 1.3%. Staged episodes of radiofrequency neurotomy were
performed in 23.9% of patients and more than 2 episodes for radiofrequency neurotomy in
6.9%, in lumbar spine and 19.6% staged and 5.1% more than 2 episodes in cervical spine of
patients in 2018.
Limitations: This analysis is limited by inclusion of only the FFS Medicare population, without
adding utilization patterns of Medicare Advantage plans, which constitutes almost 30% of the
Medicare population.
Conclusions: Even after adjusting for inflation, there was a significant increase |
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ISSN: | 1533-3159 2150-1149 |
DOI: | 10.36076/ppj.2020/23/S129 |