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Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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The new definition of cardiovascular leadership

by Andrew Hresko November 13, 2014

During our research on cardiovascular service line leadership structures for our recently launched 2014-2015 Cardiovascular Roundtable national meeting, we often heard that CV administrator’s responsibilities and required skills sets are rapidly changing.

Not long ago, CV administrators focused primarily on service line operations. Key responsibilities included personnel management, improving patient throughput, and acting as the go-to-person when crises in patient care or staff relations arose.

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Can new clinical technology save you money? Putting bioabsorbable stents to the test.

Brian Contos November 7, 2014

Recently a member asked me whether new technology will impact value creation for CV programs. In the context of catheter-based revascularization, my answer was "maybe."

As interventional cardiology programs are increasingly asked to find cost savings while maintaining high quality outcomes, they may find that technology is an untapped source of value.

For a long time, providers and regulators evaluated new technology according to its safety, efficacy, and ability to facilitate profitable revenue growth. Broader economic benefit was a secondary concern and was largely focused on the inpatient episode. But times are changing.

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Readmission penalty increases to 3%—are you prepared?

by Olivia Ley October 28, 2014

While it might be hard to believe we’re entering the third year of the Readmission Reduction Program, the new ruling announcing an increase in the maximum penalty from its initial 1% (2013) to 3% beginning in 2015 is a clear signal from CMS that performance expectations have been raised.

The good news? The Cardiovascular Roundtable has created an easy to use, objective oriented, toolkit to help you overcome the most common readmission reduction challenges.

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Exclusive transcatheter mitral valve repair benchmarks

Brian Contos , Megan Tooley October 14, 2014

Earlier this summer, we shared new transcatheter aortic valve replacement (TAVR) benchmarks from the most recent set of Medicare Provider Analysis and Review (MEDPAR) data.

But aortic valves aren’t the only transcatheter valve procedure in the game–this year, we’ve also compiled benchmarks for transcatheter mitral valve repair (TMVR) cases based on the latest MEDPAR data. This data set includes cases performed in FY 2013, which spans from Oct. 1, 2012 to Sept. 31, 2013.

Below you’ll find early data on volumes, patient demographics, and reimbursement for TMVR cases. To the best of our knowledge, these are the first benchmarks of their kind on MitraClip procedures performed in the United States.

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Would you be my (medical home) neighbor?

October 8, 2014

Just last month, the National Committee for Quality Assurance (NCQA) recognized the 8,000th patient-centered medical home – and that’s just the number of medical homes that are formally recognized, not including the many that operate without formal recognition. The role of primary care is emphasized in many of the care transformation efforts, such as medical homes and ACOs.

In fact, our colleagues over on the Medical Group Strategy Council just posted a great blog explaining the difference between a number of these clinical care redesign efforts, including the patient-centered medical home model.

However, the increasing popularity of these primary care-focused entities has left a lot of our members wondering “What is CV’s role in primary care redesign?”

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How is the two-midnight rule affecting your bottom line?

by Jeffrey Rakover and Eric Fontana October 7, 2014

The two-midnight rule remains a top-of-mind issue for CV service lines. We recently analyzed its potential financial impact—and some providers have already reported significant decreases in inpatient cases and overall revenue declines due to the shift to lower paying outpatient status.

Yet the impact of the rule differs significantly based on a patient's diagnosis or procedure performed. For instance, the base rate Medicare outpatient payment for ICD implants actually exceeds the reimbursement for comparable, low-acuity inpatients. The same is true for cardiac ablation.

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CV executives survey: Align your priorities with those of hospital executives

by Olivia Ley September 23, 2014

Increasingly, we’re seeing the role of the CV administrator extend beyond the traditional bounds of inpatient operational and program management. As service line accountability widens across more of the care continuum, CV administrators are taking on more strategic responsibilities.

But how should you be setting your strategy? With so many competing priorities, it is imperative that CV service line leaders are working in alignment with the C-suite. The Cardiovascular Roundtable recently surveyed our membership to find out what components of the CV services line hospital executives view as critical keys to success.

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Some love below the heart: New guidelines for appropriate use of peripheral vascular interventions

by Julie Bass September 8, 2014

CV services are facing increasing scrutiny over the appropriateness of diagnostic tests and procedures, coupled with pressure to contain costs while improving quality.

As a result, CV leaders must develop strategies to right-size utilization, and ensure each service is provided for the right patient at the right time.

Related: Our webconference on appropriate use in CV services

Fortunately, medical societies continue to offer increasing support through appropriate use criteria (AUC), which CV programs can implement to ensure principled utilization. However, the focus had been primarily on coronary procedures, largely overlooking peripheral vascular interventions—until now.

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