In the current climate of increasing health care spending, many efforts aim to curb costs without compromising patient care. The Independent Payment Advisory Board, created under the Affordable Care Act in 2010, is one such effort; its sole purpose is to reduce costs through modification of Medicare reimbursement rates on the basis of clinical efficacy.1 In gynecology, the cost of various routes of hysterectomy will likely come under scrutiny because nearly 600,000 hysterectomies are performed annually in the United States.3
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