Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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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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Gain insight into utilization trends in your region

By Marissa Schwartz July 29, 2015

In today’s rapidly changing and competitive CV landscape, visibility into regional Medicare utilization rates is a growing imperative. Additionally, the ability to access market-specific CV utilization data is key for the integration of population health management into the CV service line.

In order to help members understand utilization rates in their region, we developed the Regional Utilization Profiler. Read on to discover how you can use this tool in your strategic planning process.

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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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Why CV leaders should care about the new CMS bundle proposal

By Kristen Barlow Rand July 22, 2015

While CMS has been experimenting with bundled payment pilots for some time—most notably, the Bundled Payments for Care Improvement (BPCI) Initiative—for the first time, CMS has proposed mandatory bundled payments.

The new initiative, the Comprehensive Care for Joint Replacement Model, would mandate that hospitals in at least 75 locations, which include areas like Miami and New York City, be held accountable for the quality and costs of care for an entire hip and knee replacement surgery episode of care—from the time of the surgery through 90 days after discharge.

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Mobile health coach app for CV patients: Q&A with Centura Health

By Julie Bass and Kristen Barlow Rand July 20, 2015

In April, IBM announced a new business unit, called Watson Health, a cloud-based service designed to aggregate health information from electronic devices. The ultimate goal of Watson Health is to use the data to create mobile apps for providers and patients to create individualized treatment plans.

Centura Health, a network of 15 hospitals across Colorado and western Kansas, recently partnered with IBM Watson to create a mobile app for their heart and vascular patients called "CaféWell Concierge." To learn more, we spoke with the VP of the Centura Health Heart and Vascular Network, Jon Gardner, to get his perspective on key elements behind the app’s development and implementation.       

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CMS announces new value-based payment model for preventive CV care

By Kristen Barlow June 2, 2015

According to the Centers for Disease Control and Prevention, approximately 600,000 people die of heart disease in the United States every year—a statistic CMMI cites as a driver for creating new prevention models aimed at reducing the $315 billion annual price tag heart disease carries, as well as the high mortality rates from cardiovascular disease.

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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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