{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:06:27Z","timestamp":1788361587294,"version":"build-2803163510"},"reference-count":12,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/100009931","name":"Michigan Department of Health and Human Services","doi-asserted-by":"publisher","award":["E20233700-00"],"award-info":[{"award-number":["E20233700-00"]}],"id":[{"id":"10.13039\/100009931","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2023,10,21]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Approximately 1 in 10 patients undergoing surgery is considered at high risk for poor pain and opioid-related outcomes due to chronic pain or persistent opioid use prior to surgery, leading to increased hospital lengths of stay, emergency department visits, hospital readmissions, and worse long-term outcomes. Multidisciplinary transitional pain services (TPSs) have been shown to effectively identify and optimize high-risk patients before surgery, leading to a reduction in healthcare utilization. We conducted a series of semistructured interviews, a literature search, and a financial analysis to develop a reproducible business case for establishing a TPS. These interviews involved discussions with clinicians and administrators at Michigan Medicine, as well as leaders of TPS initiatives at peer institutions across the USA and Canada. The aim was to understand possible operational structures and potential sources of revenue and cost savings that needed inclusion in our model. Subsequently, the authors developed a modifiable financial modeling tool, which is freely available for download and adaptable to any healthcare institution. The model suggests that the primary source of cost savings can be attributed to a reduction in length of stay. Furthermore, several operational options exist for incorporating a TPS that performs at breakeven or positive net profit. This tool and these findings are important for informing health systems of operational and financial considerations when implementing a TPS program. Future research should evaluate this financial tool\u2019s reproducibility in community health system contexts.<\/jats:p>","DOI":"10.1136\/rapm-2023-104992","type":"journal-article","created":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T12:00:12Z","timestamp":1702728012000},"page":"1-4","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Financial model for a transitional pain service at a large tertiary academic center in the USA"],"prefix":"10.1136","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9913-8466","authenticated-orcid":false,"given":"Caroline S","family":"Zubieta","sequence":"first","affiliation":[{"name":"University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Michigan Ross School of Business, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Shabet","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Michigan Ross School of Business, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Lin","sequence":"additional","affiliation":[{"name":"Michigan Ross School of Business, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelio","family":"Muzaurieta","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Michigan Ross School of Business, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akul","family":"Arora","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Michigan Ross School of Business, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazanin","family":"Maghsoodi","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Michigan Ross School of Business, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad M","family":"Brummett","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, USA"},{"name":"Opioid Prescribing Engagement Network, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA"},{"name":"Opioid Research Institute, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Edelman","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,12,16]]},"reference":[{"key":"2025101109425320000_50.1.1.1","unstructured":"Ahmad FB , Rossen LM , Sutton P . 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