Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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The FY 2018 Inpatient Proposed Rule: Early insights for CV leaders

Megan Tooley April 21, 2017

April showers bring May flowers and—this year, at least—CMS's FY 2018 Inpatient Prospective Payment System (IPPS) proposed rule. Per usual, this rule outlines CMS's proposed updates to inpatient reimbursement for acute and long term care hospitals as well as changes to policy and quality reporting requirements for these providers. If approved, these changes will go into effect on October 1, 2017.

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How to increase radial access—and potentially save $1M per year

by Megan Tooley and Marissa Schwartz March 22, 2017

Over the past several years, there's been mounting evidence that radial access is superior to femoral access when it comes to percutaneous coronary intervention (PCI). But despite its benefits, many programs still struggle with radial access adoption. Read on for best practice strategies to improve radial access rates. 

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What you need to know about 3 new cardiovascular guidelines

by Marissa Schwartz and Catherine Kosse March 8, 2017

With all of the emails coming into your inbox as a CV leader, it can be easy to overlook the most relevant clinical guidelines from CV-related societies. But it's important to stay abreast of these changes to ensure your CV program uses the most progressive treatments possible.

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How a 'Novel' approach can make your anticoagulation clinic more important than ever

by Daniel Roza February 22, 2017

Novel Oral Anticoagulants (NOACs) have been receiving increasing attention as alternatives to warfarin in mitigating stroke risk for atrial fibrillation (AF) patients. These drugs may pose a threat to the over 3,000 anticoagulation clinics across the country that base their business on the maintenance and management of warfarin treatments.

But NOACs are far from an excuse to close up shop—instead, their rise can be seen as an opportunity for anticoagulation clinics to cement their foundational role as a center for care management.

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What's changed with TAVR? 4 takeaways from the TVT Registry Report

by Marissa Schwartz February 8, 2017

Transcatheter aortic valve replacement (TAVR) and structural heart services remain a key priority for many CV programs—particularly as recent clinical and regulatory changes have driven significant growth and expansion of the eligible patient population.

Amidst these exciting and rapidly shifting dynamics, a new report from the STS/ACC Transcatheter Valve Therapy (TVT) Registry paints a clear picture of TAVR in real world use.  

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Medical management of vascular conditions gaining prominence in the new year

Aaron Mauck January 5, 2017

Vascular care has been traditionally designed around the procedure, often at the expense of preventative and rehabilitative care strategies.

While this has also been the case in cardiac care, the disparity is particularly pronounced in vascular services, where ambiguous data concerning the efficacy of medical management, coupled with limited financial incentives for prevention or rehabilitation, has often limited emphasis to procedural options. But this is slowly changing.

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How health care “consumerism” is impacting CV

by Julie Bass December 15, 2016

The health care market today is riding a patient consumerism wave. The concept of the “empowered patient consumer” may be old news to CV leaders, but the impact is only getting stronger. Health care consumers are in fact becoming increasingly selective in how they choose and access care.

And it’s not just patients—payers, referring physicians, and even employers are directing patients as they too become increasingly accountable for care value. Each of these consumers is looking for common characteristics: good outcomes, low costs, experience, and access.

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How Banner Hospital cut its heart failure readmission rate in half

by Daniel Roza November 14, 2016

CMS’s cardiac bundling proposal has everyone thinking about ways to cut down on costs while maintaining high-quality care delivery.

As one of the most significant contributors to spending, post-acute care (PAC) is increasingly top-of-mind for hospitals—particularly CV leaders. Post-acute care typically constitutes 5% of spending for a procedural patient, but can represent up to 15% for a medical condition like heart failure, leading CV practices to be particularly vulnerable to PAC costs.

Lack of alignment between CV practices and PAC providers can result in lower quality of care and costly readmissions, and many PAC providers face difficulties in meeting the performance expectations of hospitals without some degree of structured support. As such, progressive CV programs are using cross-continuum care pathways that span inpatient, outpatient, and post-acute settings.

At Banner Heart Hospital in Arizona, CV leaders take an active role in setting and maintaining high expectations for their PAC providers.

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