Issues in health care: Interventional pain management at the crossroads

Pain Physician

Volumn 10, Issue 2, 2007, Pages 261-284

  Manchikanti, Laxmaiah ^a,b,d   Hirsch, Joshua A ^c  

^a PAIN MANAGEMENT CENTER OF PADUCAH   (United States)

^b University of Louisville School of Medicine   (United States)

^c HARVARD MEDICAL SCHOOL   (United States)

^d NONE   (United States)

Author keywords

Ambulatory surgery center reform; Interventional pain management; National health spending; Pay for performance; Physician payment reform; Sustainable growth rate formula

Indexed keywords

AMBULATORY SURGERY; ARTICLE; CHRONIC PAIN; COST CONTROL; COST EFFECTIVENESS ANALYSIS; DRUG COST; EVIDENCE BASED MEDICINE; GOVERNMENT REGULATION; HEALTH CARE COST; HEALTH CARE FINANCING; HEALTH CARE MANAGEMENT; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH CARE UTILIZATION; HEALTH ECONOMICS; HOSPITAL COST; HUMAN; INTERVENTION STUDY; MEDICAID; MEDICAL FEE; MEDICARE; PAIN; PRIVATE HEALTH INSURANCE; SUSTAINABLE DEVELOPMENT; UNITED STATES;

EID: 34147111839     PISSN: 15333159     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (67)

1. Iglehart JK. Health care on the hill - Democrats set the agenda. N Engl J Med 2007; 356:1-4.
2. Biles B, Nicholas LH, Cooper BS, Adrion E, Guterman S. The cost of privatization: Extra payments to Medicare advantage plans - updated and revised. 2006: The Commonwealth Fund.
3. Robinson JC. The commercial health insurance industry in an era of eroding employer coverage. Health Aff (Millwood) 2006; 25:1475-1486.
4. Congressional Budget Office Economic and Budget Issue Brief. The sustainable growth rate formula for setting Medicare's physician payment rates. September 6, 2006.
5. Poisal JA, Truffer C, Smith S, Sisko A, Cowan C, Keehan S, Dickensheets B. Expenditures Team NH. Health spending projections through 2016: Modest changes obscure Part D's impact. Health Aff (Millwood) 2007; 26:242-253.
6. Catlin A, Cowan C, Heffler S, Washington B; National Health Expenditure Accounts Team. National health spending in 2005: The slowdown continues. Health Aff (Millwood) 2007; 26:142-153.
7. United States Government Accountability Office. Report to the Chairman, Committee on Finance, US Senate. Steps Taken to Improve Federal Oversight but Other Actions Needed to Sustain Efforts. Medicaid Financial Management. GAO-06-705, June 2006.
8. National Governors Association and National Association of State Budget Officers, The Fiscal Survey of States, vii, June 2006. www.nasbo.org/ Publications/pdfs/FiscalSurveyJune06.pdf
9. Iglehart JK. Medicaid revisited - Skirmishes over a vast public experience. N Engl J Med 2007; 356:734-740.
10. Ginsburg PB, Strunk BC, Banker MI, Cookson JP. Tracking health care costs: Continued stability but at high rates in 2005. Health Aff (Milwood) 2006; 25:w486-w495.
11. Kuhn HB. (Letter) Department of Health and Human Services, Centers for Medicare and Medicaid Services, to Glenn Hackbarth, Chair, Medicare Payment Advisory Commission, 7 April 2006. www.cms.hhs.gov/ SustainableGRates-ConFact/Downloads/MedPAC_Letter_Estimated_2007.pdf
12. Bush J. Market principles: The right prescription for Medicaid. Stanford Law Pol Rev 2006; 17:33-55.
13. Brown K. Health insurance spending continues climb. Austin Business Journal, October 13, 2006. austin.bizjournals.com/austin/stories/2006/10/ 16/focus5.html
14. BLS, Consumer Price Index. www.bls.gov/cpi/home.htm#data
15. Generic Pharmaceutical Association, "Statistics." www.gphaonline.org/ content/NavigationMenu/AboutGenerics/Statistics/ Statistics.htm
16. Gross DJ, Gross L, Schondelmeyer SW, Raetzman SO. Trends in manufacturer prices of brand name prescription drugs used by older Americans - 2005 year-end update. April 2006. assets. aarp.org/rgcenter/health/ dd134_drug-prices.pdf
17. CMS. "Four Quarter Moving Average Percent Change in the CMS Medicare Economic Index Using Global Insight Inc. Forecast Assumptions, by Expense Category: 1990-2016. www.cms.hhs.gov/MedicareProgram-RatesStats/ downloads/mktbskt-economic-index.pdf.
18. The statement of Donald B. Marron, Acting Director, Congressional Budget Office, Medicare's Physician Payment Rates and the Sustainable Growth Rate, before the Subcommittee on Health of the House Committee on Energy and Commerce (July 25, 2006), Appendix A.
19. Manchikanti L. Medicare in interventional pain management: A critical analysis. Pain Physician 2006; 9:171-197.
20. O'Sullivan J. CRS Report for Congress. Medicare: Payments to Physicians. Congressional Research Service. The Library of Congress. April 17, 2006.
21. MedPAC. Medicare Payment Policy, Report to the Congress, March 2006.
22. Centers for Medicare and Medicaid Services. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2007 and Other Changes to Payment Under Part B. www.cms.hhs.gov/ Physician-FeeSched
23. Medicare Payment Advisory Commission, Report to the Congress: Medicare Payment Policy (Washington, D.C., March 2006).
24. Medicare Payment Advisory Commission, Medicare in Rural America, Report to Congress, June 2001.
25. United States Government Accountability Office. Medicare Physician Payments, Considerations for Reforming the Sustainable Growth Rate System. GAO-05-326T, (Washington, D.C.: Feb. 10, 2005).
26. MedPAC, Issues in a Modernized Medicare Program, Report to the Congress, June 2005.
27. Centers for Medicare and Medicaid Services. Proposed Calendar Year 2007 Update to the Ambulatory Surgical Center Covered Procedures List. www.cms.hhs.gov/ASCPayment
28. GAO Report. United States General Accounting Office. Payment for Ambulatory Surgical Centers Should be Based on the Hospital Outpatient Payment System. GAO Publication No. GAO-07-86, November 2006.
29. Epstein AM. Pay for performance at the tipping point. N Engl J Med 2007; 356:515-517.
30. Rosenthal MB, Landon BE, Normand SLT, Frank RG, Epstein AM. Pay for performance in commercial HMOs. N Engl J Med 2006; 355:1895-1902.
31. Deficit Reduction Act of 2005. S. 1932 Section 5001 Public Law No. 109-171.
32. Centers for Medicare and Medicaid Services. Medicare "Pay for Performance (P4P)" Initiatives. www.cms.hhs.gov/apps/media/press/ release.asp?Counter=1343
33. CMS Media Affairs: Medicare takes key step toward voluntary quality reporting for physicians. October 28, 2005.
34. Doran T, Fullwood C, Gravelle H, Reeves D, Kontopantelis E, Hiroeh U. Pay-for-performance programs in family practices in the United Kingdom. N Engl J Med 2006; 355:375-384.
35. Rosenthal MB, Frank RG. What is the empirical basis for paying for quality in health care? Med Care Res Rev 2006; 63:135-157.
36. Petersen LA, Woodard LD, Urech T, Daw C, Sookanan S. Does pay-for-performance improve the quality of health care? Ann Intern Med 2006; 145:265-272.
37. Lindenauer PK, Remus D, Roman S, Rothberg MB, Benjamin EM, Ma A, Bratzler DW. Public reporting and pay for performance in hospital quality improvement. N Engl J Med 2007; 356:486-496.
38. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academies Press, 2001.
39. National Health care Quality Report, 2005. Rockville, MD: Agency for Health care Research and Quality, 2005. www.ahrq.gov/qual/nhqro5/ nhqro5.htm.
40. McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, Kerr EA. The quality of health care delivered to adults in the United States. N Engl J Med 2003; 348:2635-2645.
41. Jha AK, Li Z, Orav EJ, Epstein AM. Care in U.S. hospitals - the Hospital Quality Alliance program. N Engl J Med 2005; 353:265-274.
42. Zhan C, Miller MR. Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization. JAMA 2003; 290:1868-1874.
43. Chassin MR, Galvin RW. The urgent need to improve health care quality: Institute of Medicine National Roundtable on Health Care Quality. JAMA 1998; 280:1000-1005.
44. Institute of Medicine. Leadership by example: coordinating government roles in improving health care quality. Washington, DC: National Academies Press, October 2002.
45. Berwick DM, DeParle NA, Eddy DM, Ellwood PM, Enthoven AC, Halvorson GC, Kizer KW, McGlynn EA, Reinhardt UE, Reischauer RD, Roper WL, Rowe JW, Schaeffer LD, Wennberg JE, Wilensky GR. Paying for performance: Medicare should lead. Health Aff (Millwood) 2003; 22:8-10.
46. Millenson ML. Pay for performance: the best worst choice. Qual Saf Health Care 2004; 13:323-324.
47. Chassin MR. Achieving and sustaining improved quality: lessons from New York State and cardiac surgery. Health Aff (Millwood) 2002; 21:40-51.
48. Hibbard JH, Stockard J, Tusler M. Hospital performance reports: impact on quality, market share, and reputation. Health Aff (Millwood) 2005; 24:1150-1160.
49. Marshall MN, Shekelle PG, Leatherman S, Brook RH. The public release of performance data: what do we expect to gain? A review of the evidence. JAMA 2000; 283:1866-1874.
50. Rosenthal MB, Fernandopulle R, Song HR, Landon B. Paying for quality: providers' incentives for quality improvement. Health Aff (Millwood) 2004; 23:127-141.
51. Dudley RA, Frolich A, Robinowitz DL, Talavera JA, Broadhead P, Luft HS. Strategies to support quality-based purchasing: a review of the evidence. Rockville, MD: Agency for Health care Research and Quality, July 2004. AHRQ Publication No. 04-0057.
52. Werner RM, Asch DA. The unintended consequences of publicly reporting quality information. JAMA 2005; 293:1239-1244.
53. Schauffler HH, Mordavsky JK. Consumer reports in health care: do they make a difference? Annu Rev Public Health 2001; 22:69-89.
54. Robinowitz DL, Dudley RA. Public reporting of provider performance: can its impact be made greater? Annu Rev Public Health 2006; 27:517-536.
55. Krumholz HM, Rathore SS, Chen J, Wang Y, Radford MJ. Evaluation of a consumer-oriented Internet health care report card: The risk of quality ratings based on mortality data. JAMA 2002; 287:1277-1287.
56. Walter LC, Davidowitz NP, Heineken PA, Covinsky KE. Pitfalls of converting practice guidelines into quality measures: lessons learned from a VA performance measure. JAMA 2004; 291:2466-2470.
57. Vladeck BC. Ineffective approach. Health Aff (Millwood) 2004; 23:285-286.
58. Fairbrother G, Hanson KL, Friedman S, Butts GC. The impact of physician bonuses, enhanced fees, and feedback on childhood immunization coverage rates. Am J Public Health 1999; 89:171-175.
59. Norton EC. Incentive regulation of nursing homes. J Health Econ 1992; 11:105-128.
60. Epstein AM, Lee TH, Hamel MB. Paying physicians for high-quality care. N Engl J Med 2004; 350:406-410.
61. Boswell MV, Shah RV, Everett CR, Sehgal N, Mckenzie-Brown AM, Abdi S, Bowman RC, Deer TR, Datta S, Colson JD, Spillane WF, Smith HS, Lucas-Levin LF, Burton AW, Chopra P, Staats PS, Wasserman RA, Manchikanti L. Interventional techniques in the management of chronic spinal pain: Evidence-based practice guidelines. Pain Physician 2005; 8:1-47.
62. Boswell MV, Trescot AM, Datta S, Schultz DM, Hansen HC, Abdi S, Sehgal N, Shah RV, Singh V, Benyamin RM, Patel VB, Buenaventura RM, Colson JD, Cordner HJ, Epter RS, Jasper JF, Dunbar EE, Atluri SL, Bowman RC, Deer TR, Hansen HC, Staats PS, Smith HS, Burton AW, Kloth DS, Giordano J, Manchikanti L. Interventional Techniques: Evidence-based Practice Guidelines in the Management of chronic spinal pain. Pain Physician 2007; 10:7-112.
63. Weiner DK, Kim YS, Bonino P, Wang T. Low back pain in older adults: Are we utilizing health care resources wisely? Pain Med 2006; 7:143-150.
64. Specialty Utilization data files from CMS: www.cms.hhs.gov/physicians/ pfs/
65. Iglehart JK. The new era of medical imaging - progress and pitfalls. NEJM 2006; 354:2822-2828.
66. MedPAC, Issues in a Modernized Medicare Program, Report to the Congress, June 2005.
67. Manchikanti L, Staats PS, Singh V, Schultz DM, Vilims BD, Jasper JF, Kloth DS, Trescot AM, Hansen HC, Falasca TD, Racz GB, Deer TR, Burton AW, Helm S, Lou L, Bakhit CE, Dunbar EE, Atluri SL, Calodney AK, Hassenbusch S, Feler CA. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician 2003; 6:3-80.