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Many other commenters also emphasized the point that the cost of completing the survey would come at the expense of the hospital's ability to provide essential care to patients and quoted the GAO's 2006 report to the Congress in which the GAO concluded that the surveys it conducted created a considerable burden for hospitals and that to submit the required price data hospitals had to divert staff from their normal duties, thereby incurring additional costs. Many commenters stated that the financial burden of completing the survey would be exacerbated by upcoming Medicaid and Medicare reductions under the Inflation Reduction Act

Our protocol adjustments for Fitzpatrick IV-V patients using the GHK-Cu stack include more conservative SkinPen depth settings, lower needle density on the first session, an extended recovery window between sessions compared to lighter skin types, consistent mineral sunscreen guidance beginning two weeks before the first session, and careful timing to avoid treating recently tanned skin

doi:10.4103/1673-5374.213548 Borenstein R, Hanson BA, Markosyan RM, et al

It's the only component that reflects physician effort independent of geography or setting