Posts in Category: heart failure awareness week

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.

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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