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Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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Before you bundle: Review episodic spending data for common CV conditions

Brian Maher April 14, 2014

Time and again, CV leaders have told us that bundled payments are challenging to implement. But during this year’s research, we isolated a common cause: participants are struggling to make sense of CV patients’ utilization and spending patterns once they leave the hospital.

So with our Data and Analytics Group, we’ve put together a new tool, the Episodic Cost Profiler, to help you estimate population-level spending patterns on select CV conditions and procedures.

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CV service distribution: The decision aids you need

April 7, 2014

Olivia Ley, Cardiovascular Roundtable

More and more CV leaders have to make challenging decisions about how to distribute services across sites. This not only means thinking more strategically about where and when to offer new services, but, in some cases, when it’s necessary to consolidate programs.

And while these decisions will never be easy, you have resources at your disposal that make them easier.

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One way to make discharge education stick: Group discharge sessions

March 19, 2014

Andrew Hresko, Cardiovascular Roundtable

CV leaders know that post-discharge self-management plans are crucial to avoiding readmissions. For more than a decade, studies have shown that discharge planning can reduce readmission risk for heart failure (HF) patients. But these plans are only effective when patients are willing and able to comply.

To make sure patients can adhere to these directions, programs must provide thorough education on self-management skills. However, education often becomes a “cram session” that occurs shortly before discharge, when patients and family are anxious and less able to process complex instructions.

Fortunately, you don’t need to revamp your entire discharge planning approach to make instructions stick. CV leaders at South Nassau Communities Hospital in Oceanside, N.Y., supplement traditional one-on-one bedside delivery with group HF education sessions.

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10 steps to lower TAVR length of stay from The Queen's Medical Center

March 10, 2014

Megan Tooley, Cardiovascular Roundtable, and Dr. Christian Spies, The Queen’s Medical Center

It’s been over two years since the FDA approved the first transcatheter aortic valve replacement (TAVR) device for use in the United States, and interest in the groundbreaking procedure—and the opportunities a TAVR program can offer patients and hospitals—has not waned.

But CV leaders are now facing increasing pressure not just to develop a program that meets the robust infrastructure requirements set forth by vendors and regulators, but one that also demonstrates long-term sustainability and value to the community and hospital. This means uncovering new strategies to optimize TAVR efficiency and cost-effectiveness.

With this in mind, many programs have started focusing on reducing length of stay (LOS) for TAVR cases. Doing so not only improves clinical quality and the patient experience, but also the fiscal viability of a TAVR program under current reimbursement models.

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How to track performance under risk-based contracts

February 28, 2014

Jeffrey Rakover, Cardiovascular Roundtable

As more and more CV providers take on risk-based payment, you need to start thinking about how to track performance against these contracts. The challenge is selecting metrics that you can use across payers, contracts, and time—particularly during and after the hospital stay. While providers can’t necessarily change conflicting reporting responsibilities in the near term, they can select high-value metrics to drive overall success.

Fortunately, you have some great examples to follow. Sparks Health and Maine Heart both saw significant performance improvement after updating their dashboards of CV performance metrics, specifically in the context of bundled payment models. Here’s a look at what they include.

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How the two-midnight rule will affect your hospital

February 19, 2014

Eric Fontana, Practice Manager

CMS recently announced that it will extend the two-midnight related “probe-and-educate” period. While this sounds like a risk-free educational period, Medicare Administrative Contractors (MACs) will still be actively auditing and denying claims until September 30, 2014. So while the probe-and-educate period offers an opportunity to get up-to-speed on the rule with less RAC scrutiny, this isn’t an opportunity to sit idle.

To help you understand the potential impact of this rule on your hospital, our team has prepared custom two-midnight impact assessments for all hospitals paid under Medicare’s IPPS. These institution-specific analyses show services “at risk” of moving from inpatient to outpatient and, conversely, long-stay observation cases that may be eligible for admission as inpatients.

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What’s the relationship between surgical volumes, costs, and quality in CV?

February 10, 2014

Olivia Ley, Cardiovascular Roundtable

Many researchers have investigated the relationship between surgical volumes, patient outcomes, and operation expenses. Their findings are increasingly important for today’s providers, who are under pressure to deliver higher-quality care at lower costs. So what’s the consensus?

We’ve examined some of the top research on this subject—and by and large, it suggests that higher volumes are associated with lower costs and better quality.

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Webconference alert: Learn about the new economics of CV care

February 4, 2014

Jeffrey Rakover, Cardiovascular Roundtable

Our 2013-14 national meeting series features two presentations on the "New Economics of Cardiovascular Care." And starting this week, we’re bringing this research to offices across the country through a webconference series.

If you weren’t able to attend the meeting or you’d like to revisit the strategies you learned, join us on Feb. 5 from 3-4 p.m. ET for "The Economics of CV Care: A Market Review." Brian Maher will discuss the market forces shaping CV finances, key payment and policy updates, and the impact of risk-based contracting.

Then, tune in later this month for the kickoff of a five-part series on eliminating avoidable costs in the CV service line.

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