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COVID-19 Pandemic Reduced Utilization Of Interventional Techniques 18.7% In Managing Chronic Pain In The Medicare

Laxmaiah Manchikanti1, Vidyasagar Pampati2, Mahendra R Sanapati3

  • 1Pain Management Centers of America, Paducah, KY and Evansville, IN; LSU Health Science Center, New Orleans, LA.

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The COVID-19 pandemic caused an 18.7% decrease in interventional pain management techniques for Medicare beneficiaries from 2019 to 2020. Overall utilization declined by 22% between 2010 and 2020, despite population growth.

Keywords:
adhesiolysischronic spinal paindisc proceduresepidural injectionsfacet joint interventionsinterventional techniquesother types of nerve blockssacroiliac joint injectionsInterventional pain management

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Area of Science:

  • Pain Management
  • Healthcare Economics
  • Public Health

Background:

  • The COVID-19 pandemic significantly impacted US healthcare, increasing costs for managing musculoskeletal disorders like low back and neck pain.
  • Treatment modalities for chronic pain, including interventional techniques and opioid use, were affected.
  • Previous data (2000-2018) showed a declining trend in interventional technique utilization among Medicare beneficiaries.

Purpose of the Study:

  • To evaluate the COVID-19 pandemic's impact on interventional pain management.
  • To provide an updated assessment of interventional technique utilization in the US Medicare population (2010-2019, 2010-2020, 2019-2020).

Main Methods:

  • Analysis of utilization patterns and variables for interventional pain management techniques.
  • Data sourced from the Centers for Medicare & Medicaid Services (CMS) physician/supplier procedure summary database (2000-2020).
  • Focus on the Fee-for-Service (FFS) Medicare population.

Main Results:

  • A notable 18.7% decrease in overall interventional technique utilization per 100,000 Medicare beneficiaries occurred from 2019 to 2020.
  • Specific declines observed: epidural/adhesiolysis (19%), facet joint/sacroiliac joint blocks (17.5%), and disc procedures/nerve blocks (25.4%).
  • Contrasting earlier trends, utilization decreased annually by 0.4% (2010-2019) and 2.5% (2010-2020), reversing a prior growth period (2000-2010).

Conclusions:

  • The COVID-19 pandemic drove an 18.7% decline in interventional pain management utilization from 2019 to 2020.
  • Overall utilization decreased by 22.0% from 2010 to 2020, averaging a 2.5% annual decline.
  • This decline occurred despite significant annual increases in the Medicare population and enrollment numbers.