Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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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.

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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.

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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.

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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.

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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.

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Leveraging dedicated rounds for high-acuity patients at LifeBridge Health

By Kristen Barlow April 10, 2015

High-risk patient management requires CV leaders to implement ways to increase the visibility of these patients, as well as manage their care across the continuum. In our study Blueprint for Cardiovascular Care Management we identified priorities for enhancing both the visibility and management of complex patients.

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Don't go it alone: Getting the most out of your Cardiovascular Roundtable membership

By Kristen Barlow February 2, 2015

At the Cardiovascular Roundtable, we love helping our members with their pressing questions and up at night issues. We also want to be your strategic partner and help you not just find the right information, but also help you implement solutions that yield real, sustainable results.

Read on to learn how we partnered with a member to successfully reduce cost and length of stay (LOS) for their CABG program and how you can take your membership to the next level.

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Cardiovascular 'tumor boards:' Adventist's innovative approach to multidisciplinary care

By Julie Bass January 28, 2015

It is not breaking news that the prevalence of chronic disease is growing. The expanding co-morbid and complex CV population is straining the ability for a single provider, or even a service line, to suitably care for patients across the care continuum.

Patients frequently see multiple providers both inside and outside the CV service line, making effective multidisciplinary collaboration strategies crucial to the future of CV programs, especially as we move away from the fee-for-service environment.

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