{"id":"https://openalex.org/W56339713","doi":"https://doi.org/10.36076/ppj.2013/16/419","title":"Recommendations of the Medicare Payment Advisory Commission (MEDPAC) on the Health Care Delivery System: The Impact on Interventional Pain Management in 2014 and Beyond","display_name":"Recommendations of the Medicare Payment Advisory Commission (MEDPAC) on the Health Care Delivery System: The Impact on Interventional Pain Management in 2014 and Beyond","publication_year":2013,"publication_date":"2013-09-14","ids":{"openalex":"https://openalex.org/W56339713","doi":"https://doi.org/10.36076/ppj.2013/16/419","mag":"56339713","pmid":"https://pubmed.ncbi.nlm.nih.gov/24077189"},"language":"en","primary_location":{"id":"doi:10.36076/ppj.2013/16/419","doi":"https://doi.org/10.36076/ppj.2013/16/419","is_oa":true,"landing_page_url":"https://doi.org/10.36076/ppj.2013/16/419","pdf_url":"https://doi.org/10.36076/ppj.2013/16/419","source":{"id":"https://openalex.org/S193700400","display_name":"Pain Physician","issn_l":"1533-3159","issn":["1533-3159","2150-1149"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","jufo-1","medline","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310316371","host_organization_name":"American Society of Interventional Pain Physicians","host_organization_lineage":["https://openalex.org/P4310316371"],"host_organization_lineage_names":["American Society of Interventional Pain Physicians"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pain Physician","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"https://doi.org/10.36076/ppj.2013/16/419","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5037291100","display_name":"Laxmaiah Manchikanti","orcid":"https://orcid.org/0000-0002-4201-9063","observed_orcids":["https://orcid.org/0000-0002-4201-9063"]},"institutions":[{"id":"https://openalex.org/I142740786","display_name":"University of Louisville","ror":"https://ror.org/01ckdn478","country_code":"US","type":"education","lineage":["https://openalex.org/I142740786"]},{"id":"https://openalex.org/I4210119404","display_name":"Pain Management Center of Paducah","ror":"https://ror.org/02swzn148","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210119404"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Laxmaiah Manchikanti","raw_affiliation_strings":["Pain Management Center of Paducah, Paducah, KY, and University of Louisville, Louisville, KY"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Pain Management Center of Paducah, Paducah, KY, and University of Louisville, Louisville, KY","institution_ids":["https://openalex.org/I142740786","https://openalex.org/I4210119404"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5037291100"],"corresponding_institution_ids":["https://openalex.org/I142740786","https://openalex.org/I4210119404"],"apc_list":null,"apc_paid":null,"fwci":15.5436,"has_fulltext":true,"cited_by_count":50,"citation_normalized_percentile":{"value":0.98718356,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"5;16","issue":"5;9","first_page":"419","last_page":"440"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9785000085830688,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.9785000085830688,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.00430000014603138,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.00139999995008111,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/medicare-payment-advisory-commission","display_name":"Medicare Payment Advisory Commission","score":0.9240000247955322},{"id":"https://openalex.org/keywords/medicare-payment-reform","display_name":"Medicare payment reform","score":0.7670000195503235},{"id":"https://openalex.org/keywords/interventional-pain-management","display_name":"interventional pain management","score":0.8259999752044678},{"id":"https://openalex.org/keywords/ambulatory-surgery-centers","display_name":"ambulatory surgery centers","score":0.6779999732971191},{"id":"https://openalex.org/keywords/outpatient-clinics","display_name":"outpatient clinics","score":0.9670000076293945},{"id":"https://openalex.org/keywords/evaluation-and-management-services","display_name":"evaluation and management services","score":0.7149999737739563},{"id":"https://openalex.org/keywords/echocardiography","display_name":"echocardiography","score":0.8830000162124634},{"id":"https://openalex.org/keywords/epidural-injection","display_name":"epidural injection","score":0.953000009059906},{"id":"https://openalex.org/keywords/health-care-costs","display_name":"health care costs","score":0.6579999923706055},{"id":"https://openalex.org/keywords/affordable-care-act","display_name":"Affordable Care Act","score":0.8489999771118164},{"id":"https://openalex.org/keywords/medicare-spending","display_name":"Medicare spending","score":0.3630000054836273},{"id":"https://openalex.org/keywords/health-care-delivery-reform","display_name":"health care delivery reform","score":0.3790000081062317},{"id":"https://openalex.org/keywords/patient-cost-sharing","display_name":"patient cost sharing","score":0.4410000145435333}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7564169764518738},{"id":"https://openalex.org/C145097563","wikidata":"https://www.wikidata.org/wiki/Q1148747","display_name":"Payment","level":2,"score":0.5914056897163391},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5745763778686523},{"id":"https://openalex.org/C2776643233","wikidata":"https://www.wikidata.org/wiki/Q1414593","display_name":"Patient Protection and Affordable Care Act","level":4,"score":0.4989452362060547},{"id":"https://openalex.org/C2776534028","wikidata":"https://www.wikidata.org/wiki/Q1141363","display_name":"Medicaid","level":3,"score":0.4986073970794678},{"id":"https://openalex.org/C2776034101","wikidata":"https://www.wikidata.org/wiki/Q1509347","display_name":"Commission","level":2,"score":0.4381178915500641},{"id":"https://openalex.org/C2777526511","wikidata":"https://www.wikidata.org/wiki/Q691543","display_name":"Pace","level":2,"score":0.41626912355422974},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.35668081045150757},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.3319268822669983},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.25685733556747437},{"id":"https://openalex.org/C10138342","wikidata":"https://www.wikidata.org/wiki/Q43015","display_name":"Finance","level":1,"score":0.16528233885765076},{"id":"https://openalex.org/C13280743","wikidata":"https://www.wikidata.org/wiki/Q131089","display_name":"Geodesy","level":1,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C205649164","wikidata":"https://www.wikidata.org/wiki/Q1071","display_name":"Geography","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D006278","descriptor_name":"Medicare","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011445","descriptor_name":"Prospective Payment System","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D017048","descriptor_name":"Health Care Costs","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D020406","descriptor_name":"Medicare Payment Advisory Commission","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D059408","descriptor_name":"Pain Management","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.36076/ppj.2013/16/419","doi":"https://doi.org/10.36076/ppj.2013/16/419","is_oa":true,"landing_page_url":"https://doi.org/10.36076/ppj.2013/16/419","pdf_url":"https://doi.org/10.36076/ppj.2013/16/419","source":{"id":"https://openalex.org/S193700400","display_name":"Pain Physician","issn_l":"1533-3159","issn":["1533-3159","2150-1149"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","jufo-1","medline","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310316371","host_organization_name":"American Society of Interventional Pain Physicians","host_organization_lineage":["https://openalex.org/P4310316371"],"host_organization_lineage_names":["American Society of Interventional Pain Physicians"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pain Physician","raw_type":"journal-article"},{"id":"pmid:24077189","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/24077189","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pain physician","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.36076/ppj.2013/16/419","doi":"https://doi.org/10.36076/ppj.2013/16/419","is_oa":true,"landing_page_url":"https://doi.org/10.36076/ppj.2013/16/419","pdf_url":"https://doi.org/10.36076/ppj.2013/16/419","source":{"id":"https://openalex.org/S193700400","display_name":"Pain Physician","issn_l":"1533-3159","issn":["1533-3159","2150-1149"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","jufo-1","medline","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310316371","host_organization_name":"American Society of Interventional Pain Physicians","host_organization_lineage":["https://openalex.org/P4310316371"],"host_organization_lineage_names":["American Society of Interventional Pain Physicians"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pain Physician","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.8199999928474426,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W56339713.pdf","grobid_xml":"https://content.openalex.org/works/W56339713.grobid-xml"},"referenced_works_count":70,"referenced_works":["https://openalex.org/W13866362","https://openalex.org/W42829208","https://openalex.org/W55707893","https://openalex.org/W57416130","https://openalex.org/W102279299","https://openalex.org/W122827644","https://openalex.org/W180460371","https://openalex.org/W181351938","https://openalex.org/W1925741719","https://openalex.org/W1987115729","https://openalex.org/W2001109004","https://openalex.org/W2002951314","https://openalex.org/W2013007174","https://openalex.org/W2020127034","https://openalex.org/W2026669675","https://openalex.org/W2029534880","https://openalex.org/W2034829637","https://openalex.org/W2037003816","https://openalex.org/W2038172375","https://openalex.org/W2059925668","https://openalex.org/W2060495535","https://openalex.org/W2070805374","https://openalex.org/W2081056459","https://openalex.org/W2088104902","https://openalex.org/W2097261167","https://openalex.org/W2098459347","https://openalex.org/W2105857447","https://openalex.org/W2107723544","https://openalex.org/W2113646328","https://openalex.org/W2125208830","https://openalex.org/W2125664913","https://openalex.org/W2128997253","https://openalex.org/W2133084250","https://openalex.org/W2133653637","https://openalex.org/W2139779556","https://openalex.org/W2142424661","https://openalex.org/W2145415050","https://openalex.org/W2149792514","https://openalex.org/W2153578872","https://openalex.org/W2156148295","https://openalex.org/W2158037744","https://openalex.org/W2163561501","https://openalex.org/W2165014123","https://openalex.org/W2166740300","https://openalex.org/W2167201870","https://openalex.org/W2279570899","https://openalex.org/W2325624995","https://openalex.org/W2330463600","https://openalex.org/W2398741312","https://openalex.org/W2409110657","https://openalex.org/W2409477810","https://openalex.org/W2413173610","https://openalex.org/W2419516746","https://openalex.org/W2783257982","https://openalex.org/W2910065161","https://openalex.org/W2916836393","https://openalex.org/W2999170761","https://openalex.org/W3133788568","https://openalex.org/W3134222996","https://openalex.org/W3135488745","https://openalex.org/W3136341021","https://openalex.org/W3138225770","https://openalex.org/W3139319261","https://openalex.org/W4213256289","https://openalex.org/W4237409521","https://openalex.org/W4252222606","https://openalex.org/W4253735667","https://openalex.org/W4254388155","https://openalex.org/W4317524522","https://openalex.org/W4319054202"],"related_works":["https://openalex.org/W7099808756","https://openalex.org/W3131608884","https://openalex.org/W55807603","https://openalex.org/W148588894","https://openalex.org/W2064946812","https://openalex.org/W2404685853","https://openalex.org/W4414264170","https://openalex.org/W1723432161","https://openalex.org/W2050160464","https://openalex.org/W4250349899"],"abstract_inverted_index":{"Continuing":[0],"rise":[1],"in":[2,6,23,29,112,140,153,157,174,178,196,204,232,248,265,278,329,334,339,363,370,421,472,477],"health":[3,47,68,76,78],"care":[4,48,69,79,175],"costs":[5,219,301],"the":[7,10,30,34,64,73,87,104,117,133,190,197,208,210,218,227,270,273,305,426,466,497],"United":[8],"States,":[9],"Affordable":[11],"Care":[12],"Act":[13],"(ACA),":[14],"and":[15,70,77,124,222,226,244,250,337,361,383,402,414,438,452],"a":[16,57,143,233,238,266,282,296,309,393,491],"multitude":[17],"of":[18,36,66,72,95,220,287,465,479,499],"other":[19],"regulations":[20],"impact":[21,464],"providers":[22,49,171],"2013.":[24],"Despite":[25],"federal":[26],"spending":[27,360,413,451],"slowing":[28],"past":[31],"2":[32],"years,":[33],"Board":[35],"Medicare":[37,88,96,318,377,449,500],"Trustees":[38],"believes":[39,130],"that":[40,131,151,163,172,184,255,396,428,469,494],"cost":[41,365,416,454],"savings":[42,427,455,478],"are":[43,50,470],"only":[44,405],"achievable":[45],"if":[46,132],"able":[51],"to":[52,99,109,193,207,237,324,456],"realize":[53],"productivity":[54],"improvements":[55],"at":[56],"quicker":[58],"pace":[59],"than":[60,156,277,308],"experienced":[61],"historically.":[62],"Consequently,":[63],"re-engineering":[65],"U.S.":[67],"bridging":[71],"divide":[74],"between":[75,229,400,436],"have":[80,446],"been":[81],"proposed":[82,467],"beyond":[83],"affordable":[84],"care.":[85],"Thus,":[86],"Payment":[89],"Advisory":[90],"Commission":[91],"(MedPAC)":[92],"envisions":[93],"alignment":[94],"payment":[97,164,185,283,353,398,434],"systems":[98],"eliminate":[100],"variable":[101],"rates":[102,186,354,399,435],"for":[103,150,202,256,284,291,295,304,341,350,355,406,440,485,502],"same":[105,134,306],"ambulatory":[106,125,442],"services":[107,225,246,356,409],"provided":[108,139,177,247,264,392],"similar":[110],"patients":[111,195],"different":[113,141],"settings,":[114,142],"such":[115,343],"as":[116,344],"physician's":[118,268],"office,":[119,269],"hospital":[120],"outpatient":[121],"departments":[122],"(HOPDs),":[123],"surgery":[126],"centers":[127],"(ASCs).":[128],"MedPAC":[129,159,182,215,252,348,391,445,487],"service":[135,152,307],"can":[136],"be":[137,187,430,457],"safely":[138],"prudent":[144],"purchaser":[145],"should":[146],"not":[147],"pay":[148],"more":[149,303],"one":[154,371,422],"setting":[155,235,280],"another.":[158],"is":[160],"also":[161,488],"concerned":[162],"variations":[165],"across":[166],"settings":[167],"encourage":[168],"arrangements":[169],"among":[170],"result":[173,362,476],"being":[176],"high":[179],"paid":[180],"settings.":[181],"recommends":[183],"based":[188],"on":[189],"resources":[191],"needed":[192],"treat":[194],"most":[198],"efficient":[199],"setting,":[200,241,326,332,336],"adjusting":[201],"differences":[203,212,228],"patient":[205,259],"severity,":[206],"extent":[209],"severity":[211],"affect":[213],"costs.":[214],"has":[216,253,489],"analyzed":[217],"evaluation":[221],"management":[223],"(E&M)":[224],"providing":[230],"them":[231],"HOPD":[234,279,292,300,325,340,352,384],"compared":[236],"physician":[239,274,285,322],"office":[240,260,311,323,331],"echocardiography":[242],"services,":[243],"multiple":[245],"ASCs":[249,439],"HOPDs.":[251],"shown":[254,447],"an":[257,330],"established":[258],"visit":[261],"(CPT":[262],"99213)":[263],"free-standing":[267,310,403],"program":[271,359,412,450],"pays":[272],"70%":[275],"less":[276],"with":[281,327],"practice":[286],"$72.50":[288],"versus":[289,313],"$123.38":[290],"setting.":[293],"Similarly,":[294],"Level":[297],"II":[298],"echocardiogram,":[299],"141%":[302],"($188.31":[312],"$452.89).":[314],"For":[315],"interventional":[316],"techniques,":[317],"payments":[319],"vary":[320],"from":[321],"$211.96":[328],"$407.28":[333],"ASC":[335],"$655.62":[338],"procedures":[342],"epidural":[345],"injections.":[346],"The":[347,463],"proposal":[349],"changing":[351],"would":[357,386,410,429,475,495],"reduce":[358,411],"beneficiary":[364,415,453],"sharing":[366,417],"by":[367,381,388,418,432],"$900":[368],"million":[369,420,460],"year.":[372,423,462],"On":[373],"average,":[374],"hospitals'":[375],"overall":[376],"revenue":[378,385,501],"will":[379],"decline":[380],"0.6%":[382],"fall":[387],"2.7%.":[389],"Further,":[390],"specific":[394],"example":[395],"aligning":[397],"HOPDs":[401,437],"offices":[404],"cardiac":[407],"imaging":[408],"$500":[419],"In":[424],"estimating":[425],"realized":[431],"equalizing":[433],"certain":[441],"surgical":[443],"procedures,":[444],"potential":[448],"about":[458],"$590":[459],"per":[461,483],"policies":[468],"discussed":[471],"this":[473],"manuscript":[474],"approximately":[480],"$1.5":[481],"billion":[482],"year":[484],"Medicare.":[486],"recommended":[490],"stop-loss":[492],"policy":[493],"limit":[496],"loss":[498],"those":[503],"hospitals.":[504]},"counts_by_year":[{"year":2022,"cited_by_count":2},{"year":2021,"cited_by_count":9},{"year":2020,"cited_by_count":3},{"year":2019,"cited_by_count":3},{"year":2018,"cited_by_count":5},{"year":2017,"cited_by_count":5},{"year":2016,"cited_by_count":7},{"year":2015,"cited_by_count":4},{"year":2014,"cited_by_count":8},{"year":2013,"cited_by_count":3},{"year":2012,"cited_by_count":1}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-06-24T00:00:00"}