January/February 2017

As the healthcare landscape continues its tectonic shifts, the old pillars—siloed organizations, unchallenged leadership, see-through accountability—are starting to totter. In their place new models are emerging, like the dyad, which pairs a respected physician leader with an accomplished administrative head to enable hospital systems and medical practices to more effectively manage their complex operations and, as importantly, stay ahead of change.

The approval of two new Current Procedural Terminology (CPT) codes acknowledges echocardiographic myocardial strain imaging and myocardial contrast perfusion echocardiography as emerging technologies, often a necessary step before a code is promoted to payable status.

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We are living in a data-rich, information-poor era of healthcare, with what feels like a chasm between where we are and where we aim to be with patients’ outcomes, quality improvement and practice growth. The gulf is overflowing with data that are both the key to our success and the hurdle holding us back.

Between the release of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) final rule and the election of a president who has promised to repeal the law that laid the groundwork for MACRA’s Quality Payment Program (QPP), uncertainty may be the only sure thing in U.S. healthcare today. Regardless of what happens to the Affordable Care Act (ACA), or to MACRA, cardiologists should begin preparing for changes in how they deliver care and are reimbursed for their work.  

Many medical practices aren’t leveraging the full potential of their physician assistants (PAs) and nurse practitioners (NPs) and aren’t capitalizing on reimbursement for their services. As a result, practices may be leaving money on the table and missing opportunities to improve productivity, efficiency and quality of care.

Legislation that would allow advanced practice providers (APPs) to supervise cardiac rehabilitation under Medicare has been bottled up in Congress for several years. But for many in the healthcare field, the larger issue is how to optimize the skills and talents of APPs across the cardiovascular service line given the changes unfolding in the delivery of patient care.

In the last two years, 89 percent of healthcare organizations suffered at least one data breach involving the loss or theft of patient data. The question, experts say, is not if a hospital will be attacked, but rather when—and how prepared its teams will be to mitigate damage.

Despite their well-documented benefits, statins are often discontinued by patients because of their equally acknowledged side effects. This has continued to fuel heated debate over how widespread—or even legitimate—these adverse events are, whether physicians give up too easily on patients who are statin intolerant and what other options exist for patients who could gain by taking their cholesterol-lowering medicine? 

Black people with atrial fibrillation (AF) experience vastly higher rates of serious coronary events, so it’s not surprising that a growing number of clinical studies are aggressively tackling the complex issues around the impact of race—as well as gender—on management and outcomes of the heart rhythm disorder.

4D flow magnetic resonance imaging (MRI) offers striking visuals of blood flow in the heart and vessels but as yet has not found a foothold in clinical practice. Congenital heart disease, and in particular the bicuspid aortic valve, may provide its point of entry.

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Tectonic shifts in healthcare delivery demand a broad collective skillset measured out among cardiologists, nurses, cardiology service line directors and practice administrators. Priorities need to focus on training and outreach from clinical, operational and financial perspectives as well as strengthening the heart team. 

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