Press Release
Avoidable Complications for Revascularization Procedures
Cost Hospitals; Financial Risk to Increase with Changing
Medicare Reimbursement Policies
ATLANTA, May 6, 2008 -- Hospitals currently cannot recover
increased costs of treating Medicare patients experiencing
certain complications associated with revascularization
procedures. Pending reimbursement changes to no longer pay
for "avoidable complications" will increase the financial
risk to hospitals. These are among the findings of a new
study conducted and funded by Cardiac Data Solutions, Inc.
(CDS), in conjunction with leading physician researchers,
and presented at the American Heart Association Quality of
Care and Outcomes Research in Cardiovascular Disease and
Stroke Conference, held April 30 to May 2, 2008 in
Baltimore.
The study focused on the average hospital costs and
reimbursement values for more than 505,000 Medicare
beneficiaries undergoing either Coronary Artery Bypass Graft
Surgery (CABG) or Percutaneous Coronary Intervention (PCI)
between October 1, 2005 and September 30, 2006. Researchers
compared results for patients who did and did not experience
selected complications.
The study found:
-- Hospitals essentially break even on revascularization
procedures where Medicare beneficiaries do not experience
in-hospital mortality or specific post-operative
complications.
-- Even with higher DRG payments and Medicare reimbursements
(between 15 and 73%), hospitals on average still lose money
when a Medicare beneficiary undergoing a revascularization
procedure experiences one of the complications studied.
For graphs representing the findings, visit:
https://www.cardiacdatasolutions.com/Home/doc/Graphs.pdf
"This study contradicts a widely held belief that hospitals
get paid more and have their costs covered when patients
experience certain complications," says April Simon, RN,
MSN, one of the researchers and CDS founder/president. The
study concluded that proposed changes by the Centers for
Medicare and Medicaid Services to eliminate incremental
payments for selected "avoidable" complications could put
even greater financial pressure on hospitals.
Simon adds, "The costs of complications should provide the
incentive for hospitals to invest in true quality
improvement efforts, focusing less on reporting and more on
making changes necessary to reduce complications."
Lead researcher for the study was Aaron Kugelmass, MD,
director of Cardiac Catheterization at Henry Ford Hospital.
Other researchers included: Phillip Brown, MD,
cardiovascular surgeon (retired) and past chairman,
Department of Surgery, Centennial Medical Center; David J.
Cohen, MD, interventional cardiologist and director,
Cardiovascular Research, Mid America Heart Institute, St.
Luke's Hospital; Matthew R. Reynolds, MD,
electrophysiologist and director, Economics and Quality of
Life Core Lab, Harvard Clinical Research Institute; and
Steven D. Culler, PhD, associate professor, Rollins School
of Public Health, Emory University.
About Cardiac Data Solutions, Inc.
Founded in 1999, Cardiac Data Solutions, Inc. (CDS) provides
consultation services, data analysis, clinical benchmarks,
management tools, research support, and leadership training
to hospitals, physicians, payors, manufacturers and the
financial community. CDS is focused solely on the
cardiovascular market with the primary mission of supporting
and improving clinical and business decisions to improve the
quality of patient care. Using a proprietary data analysis
tool with comprehensive and current data on clinical
outcomes, CDS identifies opportunities for improvement and
develops evidence-based strategies to achieve them. For more
information, visit http://www.cardiacdatasolutions.com.
CONTACT: Karen Conway, 303-564-2147, kmcassociates@aol.com
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