Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

Filtered by: Quality Hide

Want more market share? Try telecardiology.

by Julie Bass September 9, 2015

In our "on-demand" generation, it’s not surprising that virtual care is receiving a lot of attention to enhance access amidst resource constraints. To minimize time spent providing coverage to other hospitals (and thus diminishing access to CV services in the local market), many CV programs are exploring telecardiology as a solution that enables physicians to extend their geographic reach in a resource-efficient manner.

Read more »

Why CV services are overused, and how to fix the problem

By Marissa Schwartz September 2, 2015

There’s no doubt that cardiovascular disease is a killer. As the leading cause of death in the US, CV disease comprises 17% of our nation’s health expenditures, with much of the cost growth linked to noninvasive testing. A recent article published in Circulation reported on the widespread overuse of CV services in the US: the scope of the problem, its causes, and initiatives for change.

Read more »

Bundled payments: Not just a cost-reduction strategy

by Kristen Barlow August 17, 2015

Over the past few months, bundled payments have seemingly become the reimbursement reform of choice, with the Bundled Payments for Care Improvement (BPCI) Initiative in full swing and the announcement of a proposed mandatory bundled payment program for orthopedic procedures in 75 metropolitan areas.

The cost-cutting benefits of bundled payments to payers are self-evident. Under BPCI, Medicare receives a 2-3% discount on typical fee-for-service payments. However, the enthusiasm (and controversy) over bundled payments are not fueled by cost savings alone.

The promise of bundled payments is that by better aligning provider incentives, gaps in the care continuum will be filled, providers will work together to improve care while lowering costs, and patients will receive a higher quality of overall care. In our research this year, we’ve found that at least in some cases, the promise has become reality: bundled payments are encouraging providers, and payers, to find the improvement opportunities that lie at intersections of cost reduction and quality improvement.

Read more »

Inside a CMS-approved pilot CV program

by Marissa Schwartz August 10, 2015

In 2011, JAMA published a study detailing that just 50% of stent procedures logged in the National Cardiovascular Data Registry were categorized as appropriate. Since then, the focus on appropriate use for CV services has only grown, given CMS’s efforts to transition to value-based care models.

One new program, the SMARTCare pilot, was awarded a $15.8 million CMS Innovation Center grant and launched at 10 sites across Wisconsin and Florida in late May 2015.

Read more »

Think readmission reduction is hard? It's about to get harder.

Megan Tooley August 5, 2015

Readmissions have been a key concern for hospital executives ever since the Hospital Readmissions Reduction Program was created by the Affordable Care Act in 2010. And it’s no surprise why. Starting in FY 2015, up to 3% of total Medicare inpatient payments were at-risk for hospitals with excessive readmissions for 5 conditions: heart failure, acute myocardial infarction (AMI), pneumonia, chronic obstructive pulmonary disease (COPD), and knee and hip arthroplasty.

But while readmission reduction isn’t a new priority, it still remains a challenge for most programs. In the third year of penalties, 75% of eligible hospitals faced fines for excess readmissions.

And it’s about to get harder. While programs are still trying to get their footing with managing readmissions for the existing conditions, CMS is adding open heart surgery—coronary artery bypass grafting (CABG)—with the payment penalty taking effect October 2016 (FY 2017 for CMS). That means hospitals are already under the microscope: based on previous years, CMS will likely base the first round of penalties on performance from July 2012 to June 2015.

Read more »

Where PCI is the most expensive—and why cost variation matters

by Erin Lane August 3, 2015

Consumerism has been a buzzword in health care for the past several years, as we have seen patients shopping around for medical services—taking into account factors such as accessibility, quality, and cost. However, CV services have been a bit more sheltered from this trend as the main focus thus far has been on primary care and other lower cost, less time sensitive services.

However, a new study released by Blue Cross Blue Shield (BCBS) has put the spotlight yet again on high-cost cardiac procedures.

Read more »

The 411 on site-neutral payments

by Julie Bass July 28, 2015

Our Advisory Board colleagues recently suggested that Medicare’s adoption of some form of site-neutral payments is no longer a question of if, but when. Right now we’re anxiously awaiting the 2016 OPPS proposed rule to hear more about this policy that could have major implications for CV providers, but in the meantime let’s talk about the current market and the potential implications of site-neutral payments.

Read more »

Assessing the new AMI 30-day episode of care payment measure

By Kristen Barlow May 19, 2015

Acute myocardial infarction (AMI) is a condition with substantial variation in the cost of care, and CMS has begun measuring 30-day episode of care payments and reporting results on Hospital Compare. The average risk-standardized payment is $ 21,292 for an episode, but ranges from $15,251 to $27,317 across 1,846 hospitals with at least 25 cases.

Read more »

Comment Now

You must be logged in to comment

What Your Peers Are Saying

Rating: | Brian Maher | March 30, 2012

  • Manage your events
  • View your saved items
  • Manage your subscriptions
  • Update personal information
  • Invite a colleague