Abstract
BACKGROUND: In recent years, rising costs associated with managing spinal pain and other musculoskeletal disorders have been well documented. Prior to the COVID-19 pandemic, the use of interventional techniques to manage spinal pain and other musculoskeletal disorders had steadily increased. However, the pandemic disrupted chronic pain management, including interventional procedures and opioid use, reflecting a broader reduction in healthcare services.
OBJECTIVES: To provide an updated assessment of interventional technique utilization for chronic pain management in the U.S. Medicare population from 2000 to 2024.
STUDY DESIGN: Retrospective cohort study examining trends and factors influencing interventional technique use for chronic pain management within the traditional fee-for-service (FFS) Medicare population in the United States between 2000 and 2024.
METHODS: Data were obtained from the Centers for Medicare & Medicaid Services (CMS) master database, specifically the physician/supplier procedure summary, covering the years 2000 through 2024.
RESULTS: Service rates for interventional pain management per 100,000 Medicare beneficiaries significantly declined by 16.8% cumulatively from 2019 to 2024, corresponding to an average annual decrease of 3.6%. This contrasts with the 2010-2019 period, during which a cumulative increase of 14.5% was observed, along with an average annual growth rate of 1.5%. The steepest decline occurred between 2019 and 2020, with a 15.4% reduction coinciding with the onset of the COVID-19 pandemic.
LIMITATIONS: The analysis is limited to traditional (FFS) Medicare beneficiaries, excluding Medicare Advantage Plans, which represented nearly 54% of Medicare enrollment in 2024. Additionally, as with all retrospective claims-based studies, inherent limitations of coding accuracy and incomplete clinical detail apply.
CONCLUSION: From 2019 to 2024, the use of interventional pain management techniques declined significantly. Contributing factors likely include the lingering effects of COVID-19, economic pressures, the Affordable Care Act, and evolving local coverage determination (LCD) policies.