Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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Navigating the new CV accreditation landscape

Megan Tooley April 21, 2015

For years, CV service lines have pursued formal accreditation or certification to both improve clinical quality and distinguish their programs in a competitive marketplace. However, with the growing demands placed on CV programs to cut costs, many administrators are being forced to reevaluate which accreditation programs are right for them, and ensure they can gain the most value from them.

This process is complicated by the fact that the number of accreditation options is increasing. Furthermore, existing accrediting bodies are evolving the metrics of evaluation to align with value-based care, adding criteria like appropriate utilization, and patient-centered care delivery.

To navigate these complexities, the Cardiovascular Roundtable has developed a CV Accreditation Crosswalk and identified strategies programs are using to optimize their investment.

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What is your time to next appointment—and how can you improve access?

By Kristen Barlow April 13, 2015

Access to cardiovascular care is increasingly being defined by patients who want on-demand access at points of initial entry. If CV programs don’t adjust to accommodate these savvy patients, they risk losing volumes and failing to capitalize on the benefits of a more timely and accessible network.

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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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Are you ready for same-day ICD discharge?

By Julie Bass April 6, 2015

Much like same-day discharge after percutaneous coronary intervention (PCI), same-day discharge following elective ICD placement has many potential benefits – including increased bed availability, greater patient convenience and satisfaction, and the opportunity for cost savings. However, potential drawbacks of early discharge include the accentuation of mechanical complications, infection, and bleeding, among others.

A study recently published in the Journal of the American College of Cardiology (JACC) assessed the prevalence of same-day discharge after ICD placement and its associations with all-cause readmission, device-specific readmission, and death. Looking at a cohort of patients 65 years of age and older following elective ICD placement in the United States, the authors concluded same-day discharge was not significantly associated with death, all-cause readmission, or device-related readmission 90-days after discharge.

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Yes, there will be a physician shortage—but how will it impact your CV program?

By Andrew Hresko April 1, 2015

Fears about a looming national physician shortage peaked 2008 when the American Association of Medical College (AAMC) released projections on the supply and demand for physicians, forecasting an overall shortage of 159,300 physicians by 2025 at that time. Since that initial report, AAMC has continued to update their projections, recently releasing their most up-to-date numbers, as covered by the Daily Briefing in March.

Though the new report scales back physician shortage estimates fairly significantly, the implications for CV services and how CV leaders need to think about their physician needs are nuanced. Below, I walk through the AAMC’s most recent findings and suggest a framework for how to think about your own future CV specialist needs.

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Peripheral artery disease treatment is going outpatient, but what does it mean for costs?

By Andrew Hresko March 26, 2015

A few weeks ago, the New York Times published an article scrutinizing recent volume changes in peripheral vascular interventions, and my Cardiovascular Roundtable colleague Brian Contos responded with some additional data and context about how and why those changes have taken place.

A study published earlier this month in the  Journal of the American College of Cardiology  (JACC) adds to the discussion about the costs and appropriateness of treatment for peripheral artery disease (PAD). The study authors found large increases in outpatient and office-based peripheral vascular intervention since 2006, perhaps due in part to the 2008 changes to Medicare’s Outpatient Prospective Payment System (OPPS) that more greatly incentivized outpatient procedures.

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44% of hospitals to receive multiple P4P penalties—will you?

By Kristen Barlow March 24, 2015

The Affordable Care Act (ACA)’s three pay-for-performance (P4P) programs place up to 5.5% of a given facility’s inpatient payments at risk for FY 2015 – and that will increase to 5.75% in FY 2016 and 6% in FY 2017. Understanding the impact of P4P on your program’s finances is crucial, and we heard from many our members that they needed more help unpacking the impact and benchmarking their performance. In response, we developed the Pay-for-Performance Assessment tool.

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Watchman device finally gains FDA approval—what's next?

by Kristen Barlow March 20, 2015

After six years, three advisory panels, and a highly publicized approval process, Boston Scientific’s Watchman left atrial appendage (LAA) device has been approved for sale in the United States. An alternative to blood thinners and other drug therapies, Watchman presents a novel, interventional approach to stroke management in patients with atrial fibrillation (AF). The technology seals off the LAA, a vestigial structure accountable for up to 90% of all stroke-causing clots.

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