{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:39:34Z","timestamp":1792435174698,"version":"4.5.0"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cross-sectional analysis of a national Medicare administrative dataset (2023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Dual eligibility for Medicare and Medicaid is an established marker of socioeconomic vulnerability, but its association with surgeon reimbursement is uncharacterized in the lumbar laminectomy market. We evaluated whether surgeon-level dual-eligibility proportion is associated with laminectomy volume and standardized reimbursement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single-level lumbar laminectomy surgeons were identified by CPT code 63047 in the 2023 Centers for Medicare and Medicaid Services (CMS) Physician and Other Practitioners file. Dual-eligibility proportion, the share of dual-eligible beneficiaries in each surgeon\u2019s Medicare panel, was categorized into quartiles. Outcomes were laminectomy volume and mean standardized reimbursement per procedure; panel comorbidity, minority composition, behavioral health diagnoses, and rurality were also assessed. Quartile and multivariable analyses were restricted to the 3,075 surgeons (73.7%) with complete panel data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 4,170 surgeons performing 102,006 procedures. Higher dual-eligibility proportion was associated with lower standardized reimbursement (Q1, $672.81 vs. Q4, $502.53), greater beneficiary risk (Hierarchical Condition Category score, 1.11 vs. 1.38), higher minority panel composition, and more anxiety (28.88% vs. 34.21%) and depression (26.00% vs. 32.30%); all P &lt; 0.001. Each 1-percentage-point increase in dual-eligibility proportion was independently associated with $5.68 lower standardized reimbursement (\u03b2 = \u22125.676; 95% CI, \u22127.75 to \u22123.60; P &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgeons who disproportionately serve dual-eligible beneficiaries receive lower standardized reimbursement despite treating more medically and psychosocially complex patients. Because analyses required complete CMS panel data, estimates may not generalize to lower-volume or rural providers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261498031","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:48:34Z","timestamp":1792061314000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual-Eligible Patient Burden Is Independently Associated With Lower Standardized Reimbursement Among Lumbar Laminectomy Surgeons: A National Medicare Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4423-9756","authenticated-orcid":false,"given":"Alexander","family":"Kucherina","sequence":"first","affiliation":[{"name":"NYU Langone Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4673-1706","authenticated-orcid":false,"given":"Steven Govinda","family":"Persaud","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-517X","authenticated-orcid":false,"given":"Paul","family":"Mastrokostas","sequence":"additional","affiliation":[{"name":"SUNY Downstate Health Sciences University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charla","family":"Fischer","sequence":"additional","affiliation":[{"name":"NYU Langone 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