Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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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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New recommendations for echocardiography in acute CV care

By Julie Bass March 4, 2015

The European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association jointly published echocardiography guidelines in February’s issue of the European Heart Journal (also available online).

The guidelines specifically address practical applications of echocardiography in patients with acute CV conditions—including acute chest pain, heart failure, complications of myocardial infarction, and acute valvular heart disease. We explain the new recommendations below.

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Making millions stenting legs—what are the facts?

By Julie Bass February 12, 2015

Recently the front page of the New York Times featured an article that explored a number of sensitive issues regarding peripheral vascular interventions. The Cardiovascular Roundtable’s Executive Director Brian Contos contributed to the article. Cardiovascular Rounds sat down with Brian to get his thoughts on this hot-button topic.

See coverage in the Daily Briefing

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Three of our best strategies for successful discharge planning

By Kristen Barlow February 9, 2015

Once patients leave the hospital, it is crucial that they are sent home with appropriate instructions and the right support infrastructure. Failing to get the discharge planning process right can lead to readmissions and higher costs – unsatisfactory outcomes in the new healthcare environment that rewards hospitals for 30-, 60-, or even 90-day outcomes and low readmission rates.

Read on to discover how three institutions have developed strategies for perfecting the discharge planning process.

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Leverage your governance structure to engage physicians in AMC leadership

By Andrew Hresko February 4, 2015

Having robust physician leadership is a hallmark of academic medical centers (AMCs). At many times, physician involvement in administrative decisions is a definitive strength for academic medicine; at others, the difficulty of coordinating between multiple highly-respected academic department leaders can be a significant struggle. This challenge is exacerbated in CV services, where as many as five academic departments may have influence.

One solution to this problem is to instill an effective, inclusive, and collaborative governance structure for the CV service line. A governance structure encompasses the committees through which leaders develop initiatives to advance the service line, being comprised of, at minimum, an executive committee to set the service line strategy and an operations committee to implement it.

Easier said than done?  Below, learn how Wake Forest Baptist Medical Center, in Winston-Salem, NC, implemented an innovative strategy for its governance structure to engage physicians in collaborative service line leadership.

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