The ambulatory approach
There is no disputing the move toward outpatient procedures in the invasive cardiac procedural space. Percutaneous coronary intervention (PCI) shifted from 365,788 inpatient procedures in 2004 to 201,142 inpatient procedures in 2014. This dramatic change represents a 45% decrease in inpatient procedures. Similar numbers can be seen in the electrophysiology service line; from 2004 to 2014, inpatient pacemaker implantations decreased by 49%. According to the Physician/Supplier Procedure Summary report, 2014 was the first year that physicians were paid by Medicare for more outpatient than inpatient invasive cardiology procedures. Continue reading…
CMS issues final rule to delay some bundled payment models
The Centers for Medicare & Medicaid Services (CMS) has finalized a rule to delay the implementation of some bundled payment models. The final rule, posted to the Federal Register on May 19, 2017, pushes back the expansion of the Comprehensive Care for Joint Replacement (CJR) Model, the Cardiac Rehabilitation Incentive Payment Model and the care coordination models. CMS proposed the delay at the end of March. The rule pushes back the effective date for the Cardiac Rehabilitation model and some provisions of the care coordination model from July 1, 2017 to January 1, 2018. Continue reading…
Incorporating population health in next gen of bundled payments
The next generation of bundled payments should focus on population health management, researchers recently argued in a Journal of the American Medical Association report. The authors from the Corporal Michael J. Cresencz VA Medical Center, Perelman School of Medicine, Massachusetts General Hospital, and Leonard Davis Institute of Health Economics pointed out that existing bundled payment models suffer from several limitations. The alternative payment model is based on a fee-for-service payment structure and they incent providers to select the healthiest patients for care to avoid high healthcare costs. Continue reading…
Management of type 2 diabetes in 2017
More than 29 million people in the United States and 420 million globally have diabetes, with a projected global prevalence of 642 million by 2040. This accelerating pandemic comes with high personal and financial costs to the individual, society, and the economy. The expanding number of antihyperglycemic medication options for type 2 diabetes, often involving different mechanisms of action and safety profiles, can be a challenge for clinicians, and the increasing complexity of diabetes management requires a well-informed strategy for prevention and treatment of this disease. Continue reading…
SNMMI partnering with NDSC to disseminate appropriate use criteria
Clinicians referring patients for imaging with nuclear and molecular modalities will soon be able to do so with ready access to utilization assistance that’s based on appropriate-use criteria developed by the Society of Nuclear Medicine and Molecular Imaging (SNMMI). That’s because the group is working with National Decision Support Company (NDSC) to put the criteria in front of these referrers, as long as they use NDSC’s widely adopted Care Select Imaging platform, according to a news release sent by NDSC. Continue reading…
Regulatory Requirements: The impact on cardiac imaging and dose management
In recent years, radiation dose management awareness has heightened across the healthcare industry to address growing concerns around the consequences of too much exposure, and a lack of standardization around dose management protocols and practices. Industry stakeholders have responded by introducing new regulations and requirements for healthcare providers, including the CMS recent MACRA ruling along with updated Joint Commission standards which call for more stringent dose management and reimbursement requirements. Understanding exactly what prompted these changes is paramount for health systems around the world to ensure compliance and success in this evolving environment. Continue reading…
Myocardial perfusion imaging in women for the evaluation of stable ischemic heart disease—state-of-the-evidence and clinical recommendations
This document from the American Society of Nuclear Cardiology represents an updated consensus statement on the evidence base of stress myocardial perfusion imaging (MPI), emphasizing new developments in single-photon emission tomography (SPECT) and positron emission tomography (PET) in the clinical evaluation of women presenting with symptoms of stable ischemic heart disease (SIHD). The clinical evaluation of symptomatic women is challenging due to their varying clinical presentation, clinical risk factor burden, high degree of comorbidity, and increased risk of major ischemic heart disease events. Continue reading…
