Posts in Category: heart failure

CMS Delays Cardiac Bundled-Payment Program  

The Centers for Medicare and Medicaid Services (CMS) has pushed back the implementation date for its bundled payments for cardiac care from July 1 until Oct. 1, according to Cardiovascular Business. It also suggested it could further delay the model until Jan. 1, 2018.

CMS announced the delay of the program, titled the Cardiac Rehabilitation Incentive Payment Model, this week in the Federal Register.

The bundled-payment program would allow approximately 1,120 acute care hospitals in 98 designated markets to hold on to the savings they achieve if they spend less than the target price for a 90-day episode of care for bypass and heart attack patients. However, hospitals that exceed the target price must repay Medicare -- and target prices will be determined retrospectively.

CMS previously predicted that the program - which also covers knee and hip replacement - would save the federal government as much as $159 million between now and 2021. In 2014, the CMS said, heart attack treatment for 200,000 patients cost Medicare more than $6 billion.

The new Secretary of Health & Human Services, Tom Price, has been a critic of the program, objecting to the mandatory nature of the initiative. Seema Verma, the new CMS administrator, said during her confirmation hearing in February that she preferred a gradual expansion of new payment models, Cardiovascular Business reported.

The CMS announcement said an additional three-month delay is necessary to allow time for additional review, "to ensure that the agency has adequate time to undertake notice and comment rulemaking to modify the policy if modifications are warranted, and to ensure that in such a case participants have a clear understanding of the governing rules and are not required to take needless compliance steps."

CMS added that participants would have more time to prepare for these models with the delay and that it would be preferable for payment periods to align with the calendar year. As a result, the CMS said, it is seeking comment on delaying the bundles until January 2018.

 

From one hospital to another, the cost of treating heart attack patients varies by as much as 50 percent. Does your hospital have a plan to meet the target prices for bypass and heart attack patients? LUMEDX's Cardiovascular Performance Program can help. Click here to find out how.

This Week in Cardio and Health IT News 

EHR developments, top hospitals list, and more

Here are some of this week's top stories in cardiology and health IT.

Big names in healthcare pledge to facilitate interoperability, EHR accessibility

The Obama administration has announced an agreement to increase interoperability by top U.S. health information technology developers and many of their larger customers. Signing on to the pledge--which requires signees to ease patient access to electronic health records--were Allscripts, Athenahealth, and Cerner Corp., among others. About 90 percent of U.S. hospitals use at least one of the vendors who signed on. 

Top 100 Hospital List released by Truven

Truven Health Analytics has released its list of the 100 top hospitals in the United States. In researching the hospitals, Truven discovered a trend toward reduced expense per patient among the majority of top-performing hospitals. This year's trend appeared for the first time in the awards' 23-year history. 

More patients survive when hospitals adhere to cardiac arrest protocol

Hospitals that closely followed recommended care protocols after in-hospital cardiac arrest (IHCA) had the highest survival rates. That's the conclusion of a new study published in JAMA Cardiology, which found that more than 24,000 lives could be saved annually if all hospitals operated at the level of the highest-scoring provider. 

Payer-provider collaborations called key to improved patient outcomes 

Payers and hospitals must overcome their differences to reduce readmissions, according to a special report by FierceHealthcare.com. "As providers increasingly move toward value-based care models, they must work with their counterparts in the payer sector to coordinate care and prevent readmissions," the report says. "But the transition is proving bumpy in some cases due in part to the historic mistrust between payers and providers."

Questioning whether readmission rates are a reliable care quality measure

Hospital readmission rates are not an outcome, but a measure of utilization, says one Harvard School of Public Health professor. He pointed to new federal research demonstrating that hospitals don't use observation status as a way to create the appearance of decreased readmissions, which had been a concern prior to the research. Readmission rates can decline for a number of reasons, including difficulty in being readmitted or better hospital-to-patient communication, he says.

The Best of Cardio and Healthcare News for the Week of 1/11/16 

Did you have a chance to check out the latest news from the cardiology and healthIT communities? Let us help keep you up to date on the stories you won't want to miss.

Heart attack outcomes may improve when treatment sought earlier

Restoring blood flow quickly after heart attack symptoms begin is key to less heart damage, according to a new study published in JACC: Cardiovascular Interventions. The study found that failure to recognize and seek treatment for early heart attack symptoms can cause increased damage to the heart. 

Heart failure cell therapy trial gets FDA approval

The FDA has authorized Celyad’s Investigational New Drug (IND) application for a CHART-2 trial in the United States. The phase III heart failure trial will initiate clinical testing of Celyad’s C-Cure cardiopoietic cells delivered via the C-Cath proprietary catheter. CHART-2 is designed to test the efficacy of C-Cure as a treatment for heart failure of ischemic origin. 

Coronary stenting often followed by additional surgery

Nearly 15 percent of patients who received coronary stents during a PCI underwent another surgery within a year of the procedure, and nearly half had more surgery within five years, according to cardiovascularbusiness.com. The website reported that nearly 80 percent of the subsequent surgeries were noncardiac in nature.

Cardiac Assist  device preserves LV function in cardiogenic shock

XENiOS’ i-COR Synchronized Cardiac Assist system protects left ventricular (LV) function compared to continuous-flow ECLS (extracorporeal life support) in cardiogenic shock, according to data presented at the recent American Heart Association annual meeting. Synchronized cardiac assist, which superimposes a physiological pulse wave onto the patient’s weakened pulse, is intended to be a less invasive treatment than the current standard.

Optimism may lead to increased physical activity, reduced readmissions following acute coronary syndrome

Two weeks after an acute coronary syndrome, patients who were optimistic were more likely  to be physically active and less likely to be readmitted to a hospital for cardiovascular reasons, according to an observational study. But gratitude didn’t help, according to researchers, who reported that gratitude following an acute coronary syndrome was not associated with improvements in readmission or more physical activity.

 

Posted by Monday, January 11, 2016 1:01:00 PM Categories: best practices cardiology data heart failure mortality outcome

The Best of Cardio, Health IT News: Week of 12/21/15 

Did you have a chance to check out the latest news from the cardiology community? Let us help keep you up to date on the stories you won't want to miss.

Mount Sinai heart director predicts cardio care will focus more on prevention

In the future, healthcare providers will put more emphasis on prevention, and (it is hoped) less on treating disease, Valentin Fuster, M.D., Ph.D., said during a Dec. 17 panel discussion at the United Nations. Fuster, director of Mount Sinai Heart and physician-in-chief of The Mount Sinai Hospital, added that the transition “will require that cardiovascular specialists and healthcare workers are trained in ambulatory and home-based care.” 

Heart disease still top cause of deaths, but rate is decreasing in U.S.

Heart disease-related deaths are down, but still account for nearly one-third of all deaths in the United States, according to the American Heart Association's (AHA's) annual Heart Disease and Stroke Statistical Update. Cardiovascular disease caused 30.8 percent of all U.S. deaths in 2013 and is still the leading cause of death, with about 2,200 people dying of it daily in the United States. From 2003 to 2013, death rates attributed to cardiovascular disease declined 28.8 percent, the AHA reported.

Healthcare 2015: The year in review

Rising drug prices—including huge increases in the prices of some older drugs— lead Modern Healthcare’s list of top medical stories for 2015. Also on the radar: cyberattacks on health insurers, and the congressional breakthrough on “the long-standing headache of Medicare physician pay.”

Population health the big issue in healthcare IT

In the healthcare IT community, population health was one of the hot topics of 2015. That’s according to healthcareitnews.com, which closes the year with its 10 most-read population heath stories of 2015. One of the featured stories covers possible population health gains that could come about as patients become more engaged. 

Self-service kiosk lets patients share data with providers

A new self-service kiosk will allow patients and providers to share medical exam reports, radiology reports and medical images. Although it’s not yet available for commercial sale, Carestream Health’s MyVue Center Self-Service kiosk debuted recently at the 2015 Radiological Society of North America conference. 

Posted by Monday, December 21, 2015 12:14:00 PM Categories: cardiology data electronic health records health information technology health IT heart failure HIT hospitals

The Best of Cardio and Healthcare News for the Week of 12/7/15 

Good news, bad news: High cholesterol rates are down, but fewer than half of patients are taking their statins

Did you have a chance to check out the latest news from the cardiology community? Let us help keep you up to date on the stories you won't want to miss.

 

The good news: High total cholesterol rates declining among U.S. adults

Rates of total high cholesterol and low high-density protein (HDL) in U.S. adults decreased between 2011 and 2014, according to the Centers for Disease Control (CDC).  From 2009 to 2010, 13.4 percent of adults had high cholesterol and 21.3 percent had low HDL cholesterol. From 2011 to 2014, those percentages dropped to 12.1 percent and 18.5 percent, respectively.

The bad news: Most patients not making changes to reduce cardio risk

Fewer than half of patients considered candidates for cholesterol-lowering treatments are actually implementing the treatments, which include exercising more, taking statin medication and losing weight. “Cholesterol treatment gaps” are greater among non-white ethnic groups in the United States than they are for Americans who are white.

Mood matters! Patients with negative emotions before interventional procedures have more adverse outcomes    

Adverse effects after angioplasty and interventional radiology procedures are more common in patients who are fearful or distressed prior to the procedures. Patients who went in with negative emotions were more likely than those with positive or neutral emotions to experience prolonged lack of oxygen, low or high blood pressure, post-operative bleeding or an abnormally slow heart rate.

Hospital staff don’t feel prepared for a mass casualty event

Are critical care and emergency room (ER) staff ready to handle the next terrorist or other mass casualty event? Two-thirds of the physicians and nurses surveyed recently said no. They’re concerned about shortages of available surgeons, beds and blood supplies. 

What healthcare leaders must do to improve patient outcomes

Outcomes-based patient care requires a paradigm shift that has yet to occur for many in healthcare management, according to a Harvard Business Review blog post. Successfully adapting to this new business model requires investing time and money over the long haul, plus taking two other key actions, the post says.

Best of Health IT News: Week of 06/04/15 

Did you have a chance to check out the latest healthcare IT news stories around the Web? We’ve captured the top industry news stories from this week that you won’t want to miss.

An Ideal Transition: Multi-Campus Rollout of Echo CVIS at Orlando Health 

Read the latest case study from Diagnostic & Interventional Cardiology to learn how Orlando Health has successfully implemented LUMEDX's physician structured reporting and image management solution across five of its campuses. Read how the hospitals use standardized reports for echo in order to improve efficiency and streamline workflow.

Million Hearts Model Rewards Physicians for Prevention 

According to Medscape, the Center for Medicare & Medicaid Innovation (CMMI) recently announced a 5-year, randomized controlled trial to test the idea of paying physicians for reducing the long-term cardiovascular risk of their high-risk patients. CMMI will enroll 720 practices in the clinical trial between June and September, and the trial is scheduled to begin in January 2016. 

Improving Physicians' Communication Skills

Hospitals & Health Networks Daily reports on how patients are now rating their physicians' communication skills on the Center for Medicare & Medicaid Services' HCAHPS Survey. The survey shows that higher performance leads to better clinical outcomes, and the ratings will be linked to hospital reimbursements. 

Preventing Heart Attacks and Strokes with the Million Hearts Project  

Watch the latest Million Hearts whiteboard animation video, which shows how you can leverage your healthcare IT investments to prevent heart disease and stroke. Million Hearts is a national initiative partnering with other federal organizations, healthcare providers, and private-sector groups with the goal of preventing 1 million heart attacks and strokes by 2017. 

The video explains how healthcare providers can use the PDSA cycle as a way to plan interventions and drive improved patient outcomes. For more on how your heart hospital can use the PDSA cycle to support quality improvement initiatives, request your complimentary webinar CDDriving Change in Readmissions and Length of Stay: Proven Performance Improvement Methods. In this webinar, you will learn how to use the PDSA cycle to understand your hospital's data in order to manage readmissions and length of stay. 

Monday, August 25, 2014 12:54:00 PM Categories: analytics data EHR electronic health records health IT heart failure HIT industry news

Heart Healthy Tips 

Now that spring is in full bloom, what are you doing to stay heart healthy?

Wednesday, April 09, 2014 11:14:00 AM Categories: healthcare today heart failure photos

Case Study: Improving Heart Failure Readmissions Rates 

During Heart Failure Awareness Week (Feb. 9-15), the LUMEDX blog will post on topics related to heart failure program management.

In this case study, we will examine how a hospital system utilized performance improvement processes and data analysis to lower heart failure readmissions rates.

Background:

A hospital system found that its largest expense category over several years was in heart failure (HF) patients due to high readmissions rates. Hospital administrators determined that reducing readmissions rates would enable cost reduction and improve patient care.

The Model for Improvement:

With guidance from the LUMEDX Healthcare Consultants, the hospital employed the Model for Improvement as a foundation for change.

The model asks three questions:

  • What are we trying to accomplish?
  • How will we know that a change has resulted in improvement?
  • What changes can we make that will lead to improvement?

By working with LUMEDX to answer the questions above, the hospital developed concrete goals. They determined that charting current trends would provide the best basis for prediction and rapid detection of changes.

Next, LUMEDX and staff at the hospital went through a series of PDSA Cycles to test, adapt, and implement the new improvement plan – deploying a nurse case manager who would provide coaching for individual heart failure patients who had left the hospital.

During the cycles, the hospital:

  • Designed and reviewed the case manager concept with doctors, nursing staff, and hospital administration
  • Conducted small-scale tests with select groups of patients before evaluating and modifying the plan based on results
  • Summarized learnings, and implemented the final plan across the entire patient population

Conclusion:

After full implementation of the case management plan, data showed that the strategy was effective in that readmissions rates declined (see graph below).

By using data analysis, the hospital system can continue to make methodical, informed improvements in its heart failure program.

For more information on LUMEDX Healthcare Consulting, click here.

 

Heart Failure Awareness Week: Improving Your HF Program 

This week, we celebrate Heart Failure Awareness Week (Feb. 9-15) along with the Heart Failure Society of America. Statistics show that heart failure.

  • Affects 5.8 million people in the U.S., with over 600,000 more diagnosed each year;
  • Is one of the fastest growing heart disease conditions, with an expected increase of 25% by 2030;
  • And cost the U.S. $39.2 billion in 2010 through health care services, medications, and productivity losses.

We at LUMEDX understand that in addition to educating patients on heart failure facts, symptoms, and preventative measures, it is also vital to examine the care provider’s side – namely, how to tackle the many challenges associated with managing a successful heart failure program.

Heart hospitals strive to provide timely, highest quality treatment to patients across the entire continuum of care – while finding ways to reduce costs, protect reimbursements, and manage populations efficiently. With a successful heart failure program in place, hospitals can improve patient outcomes by reducing readmissions and mortality rates while also saving time and money.

It is critical for clinicians, hospital administrators, vendors, and other stakeholders to come together and share ideas on how to optimize management and treatment of heart failure patient populations – both now and moving forward.

To add to this conversation, LUMEDX invites you to join us for a complimentary webinar next week on Heart Failure outcomes analytics: Using Analytics to Identify and Manage Heart Failure Patients. The webinar will take place next Thursday, February 20 at 1pm Eastern Time. You can register by clicking here.

We will continue to post on topics related to heart failure awareness for the rest of this week, and look forward to reading your thoughts in the comments. Follow us on Twitter and Google+ for more. 

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