Cardiovascular Rounds

News, resources, and analysis from the Cardiovascular Roundtable

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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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Recently announced coding change improves financial outlook for hemodynamic support devices

by Emily Fletcher November 7, 2016

Annual coding adjustments are par for the course when it comes to CMS’s annual reimbursement updates. On rare occasions these changes can make a big difference in how hospitals are paid. This year, one such change caught our attention.

Recently the American Hospital Association released clarifying ICD-10 coding guidance that should shift hemodynamic support devices like Abiomed’s Impella device from valve MS-DRGs 216-218 to the higher reimbursed MS-DRG 215.

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Inside Community Regional Medical Center's approach to CV co-management

by Julie Bass October 13, 2016

Strengthening hospital-physician alignment is no easy feat, and it’s more important than ever as the health care industry holds providers more accountable for cross-continuum value.

Community Regional Medical Center (CRMC) in Fresno, Calif., developed its first CV co-management agreement a year ago, and has already realized benefits to its patients, physicians, and the service line.

Keep reading to learn about the seven key strategies behind the hospital's success.

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Behind the numbers: Why the hybrid OR investment decision isn't just financial

by Nadeem Farooqi and Carrie Wolf October 7, 2016

Hybrid operating room investment is a hot topic with members, as increasing complexity of interventional case mixes and rising interest in TAVR are sparking physician demand for access to these facilities. However, extremely high upfront costs are rightfully giving hospital leaders pause.

Because of this, our Service Line Strategy Advisor team has run financial analyses* for many members to evaluate the implications of hybrid OR investment. In these analyses, the five-year net present value (NPV) for hybrid OR investment is calculated based on various inputs such as standard upfront costs, incremental volume projections for hybrid OR-suitable procedures, expected reimbursement, labor, and maintenance.

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The results are in: What's the current state of hybrid OR use?

Aaron Mauck September 28, 2016

As hospitals confront rising demand for minimally invasive procedures, interest in the hybrid OR has grown among CV administrators and clinical staff alike. The hybrid OR offers advantages over the traditional surgical suite, allowing practitioners to combine surgical and interventional approaches, which is why it's no surprise the AHA reports that 75% of CV surgeons expect to be working within a hybrid OR space by 2018.

Despite the attention the hybrid OR has received, it remains unclear how programs are planning their hybrid OR investments or utilizing their existing hybrid OR suites. That's why we recently asked you to help us better understand the current state of this technology. Here's what we found.

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