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Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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How (and why) to develop a cardio-oncology partnership

January 10, 2014

Andrew Hresko, Cardiovascular Roundtable

Cardiovascular Business recently published an article exploring the emerging field of cardio-oncology, which developed from the apparent relationship between cancer treatment and cardiomyopathy. Cardiologists and oncologists alike have begun creating protocols to screen cancer survivors for developing heart problems—and some are even pursuing multidisciplinary collaborations to care for the diseases jointly.

During our national meeting research, we found that several institutions are placing a new emphasis on improving care for these complex patients through cross-service line cardio-oncology collaborations.

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Get the new imaging AUC on your cardiologists' radar

January 6, 2014

Olivia Ley, Cardiovascular Roundtable

The American College of Radiology (ACR) recently released an update to its appropriate use criteria (AUC) that includes five new CV imaging topics. This adds to the growing library of AUC available for CV services—but it can be difficult to move these guidelines from paper to practice.

Leaders at Henry Ford Hospital found a solution. We’ve mapped out their education strategy—and its results—that you can use to engage your physicians with the new CV imaging criteria.

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Succeed under HF bundled payments: Strategies to reduce risk from post-acute care providers

December 16, 2013

Jeffrey Rakover, Cardiovascular Roundtable

Many CV providers are accepting bundled payments for heart failure (HF) cases. But during our November national meeting, an attendee asked an important question: How can CV programs succeed under these payment contracts when much of the risk comes from readmissions outside their control? The attendee was particularly concerned with high readmission rates from skilled nursing facilities (SNFs).

To help you reduce this risk, I’ve pulled together a list of our best resources and profiles on preventing SNF-related readmissions and working with post-acute care providers. The approaches range in resource intensity and degree of direct engagement from sending system providers into non-affiliated SNFs to developing preferred SNF networks and improving quality by providing regular performance feedback. 

With increased attention to cost of care in the post-acute space, providers will want to consider these approaches as they work to optimize both bundled payments and readmission risk overall.

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The CV care management dictionary

December 9, 2013

Andrew Hresko, Cardiovascular Roundtable

At our national meeting, we begin our CV care management presentation with a complicated word cloud and two big questions: What do all these new terms about patient care mean? Are they just catchy buzzwords?

Care management jargon certainly can be confusing. But parsing out the nuances between the often similar-in-name and related-in-function terms is an important step in developing a coordinated CV care management strategy. We’ve defined some of these complicated terms below to provide some clarity and identify the relationships between them.

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SCAI’s expert opinion on FFR, IVUS, and OCT

November 27, 2013

Andrew Hresko, Cardiovascular Roundtable

More and more doctors are using fractional flow reserve (FFR) and optical coherence tomography (OCT) technologies to evaluate the extent of coronary artery blockage and optimize the use of coronary interventions. As we’ve discussed in the past, use of FFR—which measures the pressure drop across a stenosis—has increased exponentially over the last decade. Adoption of OCT—which creates high-resolution cross-sectional images of blockages—has not been as rapid, but physicians are excited about its potential for visualizing arteries.

Much of the interest in these tests is due to the growing scrutiny over appropriateness of PCI, as they can support CV decision making and identify the clinical need for an intervention. Although these tests can aid appropriate use decisions, they also raise a new question: How do we ensure these diagnostic invasive tools themselves are used appropriately?

See the latest appropriate use criteria for CV procedures and diagnostic tests »

To address this question, the Society for Coronary Angiography and Interventions (SCAI) has released an expert consensus statement on optimal use of FFR, OCT, and intravascular ultrasound (IVUS, the previous standard for measuring coronary artery blockage). This statement uses evidence released since the technologies were last evaluated in the 2011 guidelines for PCI to provide guidance on which technology is appropriate in various situations.

I’ve summarized three key takeaways from the new guidelines below.

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ACC to remove ‘inappropriate’ from its vocabulary—and what it means for you

Brian Maher November 7, 2013

As the Daily Briefing team reported last week, the American College of Cardiology (ACC) announced it will replace the term “inappropriate” with “rarely appropriate” when describing tests and procedures of little or no value. Moreover, the term “uncertain,” currently used to rate procedures that have unclear value given clinical circumstances, will now be coined “may be appropriate.”

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Preview the national meeting presentations your peers are raving about

Brian Maher October 31, 2013

Last week, we hosted the first session of the 2013-14 national meeting series, Unlocking Cardiovascular Value, in our Washington, D.C., office. We had a great mix of administrators, managers, and physicians attend who provided lively discussion and gave overwhelmingly positive feedback. In fact, 100% of them thought the research advanced their knowledge of how to cut CV costs, build a CV care management platform, and optimize the CV patient experience.

But don’t just take our word for it—see what attendees had to say, and preview the presentations they’re raving about.

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The 'two-midnight' rule: What you need to know

October 15, 2013

Eric Fontana, Practice Manager

While CMS has provided a "probe-and-educate period" until Sept. 30, 2014, "deny-and-educate" may be an appropriate description. Recovery Audit Contractors (RACs) may not be conducting post payment audits of your admissions to check two-midnight compliance, but Medicare Administrative Contractors (MACs) definitely are. You need to get prepared. Below are some takeaways from the new regulations that you may want to consider, including some recommendations for responding to the rule.

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What Your Peers Are Saying

Rating: | Brian Maher | March 30, 2012

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