• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Avoidable Complications for Revascularization Procedures Cost Hospitals; Financial Risk to Increase With Changing Medicare Reimbursement Policies

Posted on: Tuesday, 6 May 2008, 09:01 CDT

ATLANTA, May 6 /PRNewswire/ -- 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, Ph.D., 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

This release was issued through eReleases(TM). For more information, visit http://www.ereleases.com.

Cardiac Data Solutions, Inc.

CONTACT: Karen Conway for Cardiac Data Solutions, Inc., +1-303-564-2147,kmcassociates@aol.com

Web site: http://www.cardiacdatasolutions.com/

Source: PRNewswire

More News in this Category