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Healthcare Economics

 - health_costs

Thirty-day costs for acute MI patients on Medicare were $627 higher for admissions to PCI vs. non-PCI-capable hospitals in a recent study. This higher price tag, while relatively modest, still needs to be justified, the researchers wrote.   

 - Nurse and Patient

It sounds counterintuitive, but hospitals may save money by waiting a day before discharging heart failure patients. One more day in the hospital also reduces death from MI and pneumonia, according to a report published by the National Bureau of Economic Research.

 - Doctors Running

Patients who survive in-hospital cardiac arrests are not completely out of the woods, and mortality, readmission rates and inpatient costs prove it. Researchers found that 30-day and one-year readmission rates were exceptionally high among in-hospital cardiac arrest survivors, as were inpatient costs.

 - flat

Cardiovascular specialists will find little joy in final regulations released by the Centers for Medicare & Medicaid Services (CMS). Changes for 2015 leave payments generally flat—at least until April 1, when the Sustainable Growth Rate (SGR) formula patch is scheduled to expire.

 - Weighing Options

Heparin choice can impact costs, according to a study published online Nov. 1 in JAMA. The economic analysis found median hospital costs were $1,297 less per patient with low-molecular-weight heparin (LMWH) dalteparin as opposed to unfractionated heparin.

 

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The consequences of policy changes

You can call any change in public policy a natural experiment. This week we had a glimpse of some results.

Starting pay for cardiology subspecialists: $189K-$360K

Not bad for starters. Depending on the subspecialty, newly minted cardiologists made between $189,000 and $360,000 in 2013.

Transparent savings: Imaging claims payments drop with use of price transparency platform

Research suggests patients might be thriftier shoppers if given the right tools. When a group of patients used a price transparency platform, it resulted in lowering claims payments for advanced imaging services by more than 13 percent, according to a study published in the Oct. 22/29 issue of JAMA.

Competition among docs may keep prices in check

Market concentration may offer some efficiencies but that doesn’t guarantee savings. An analysis published in the Oct. 22/29 issue of JAMA found that insurers paid higher prices when physicians faced less competition.

Costs per patient $704 higher at multihospital vs. physician-owned practices

Patient costs can be as much as 20 percent higher in multihospital systems as opposed to physician-owned, physician-run organizations, a study published in the Oct. 22/29 issue of JAMA found. These findings contradict assumptions that larger organizations would be able to leverage size and integrated services for better pricing. 

Informal caregiving for elderly stroke patients costs $26.8B

Stroke ranks high for costs to healthcare systems. A study published online Oct. 10 in Neurology added the price of informal caregiving for elderly stroke survivors in the U.S. to the equation: almost $27 billion annually.

Reassessing readmissions

October is here. Let the pain begin. That is, the 30-day readmission penalties.

Blood, sweat & time: Why heart surgeons make more than family doctors

Differences in the time estimates for physician work accounted for almost 90 percent of the variance in a measure used to determine pay for doctors, a finding that helps explain the income gap between proceduralists and primary care physicians. The results were published online Sept. 18 in the Annals of Surgery.

As TAVR marches forward

The Transcatheter Cardiovascular Therapeutics conference in Washington, D.C., offered some reassuring findings on transcatheter aortic valve replacement (TAVR) this week, but that doesn’t mean it is a green light for expanded indications.

Treating stroke with r-tPA saves payers $25,000 per patient

The cost-effectiveness of a thrombolytic agent used to treat stroke is all but a slam dunk from a payer’s perspective, according to a study published online Sept. 4 in Stroke. The authors recommended using their updated cost analysis to inform future reimbursement policies.

It’s lights out again (and again) for Sunshine

The Centers for Medicare & Medicaid Services (CMS) will shut down the Open Payments website twice again “for maintenance.” The latest setback prompted the American Medical Association (AMA) to call for a six-month delay in the program launch.

Not-for-profit hospitals see revenue growth tumble

U.S. not-for-profit hospitals’ revenue growth hit an all-time low of 3.9 percent in 2013, Moody’s Investor Services calculated, with little relief in sight for 2014.

Novel anticoagulants vs. warfarin: Popular but pricey

Novel oral anticoagulants have outstripped warfarin for usage in the U.S., but at a price. A study found that the three new options for treating patients with atrial fibrillation made up 62 percent of new prescriptions but cost $900 higher than warfarin after six months.

A peek at TCT headliner? Keynote takes on GME funding

Could this be a preview of a keynote speech at the upcoming Transcatheter Cardiovascular Therapeutics (TCT) conference in Washington, D.C.? In an assay, economist Uwe E. Reinhardt, PhD, argued that graduate medical education (GME) did not meet the standards for receiving federal funding.

Leaping lipids! Common test costs $10 to $10,000 in California

Buyers beware. Hospitals in California charged as little as $10 and as much as $10,169 for a lipid panel test, according to an analysis published Aug. 15 in BMJ Open.

Cardiology pay slips 8% but who, what & where makes difference

Overall compensation for cardiologists dropped almost 8 percent between 2012 and 2013 but the pain was not spread evenly, according to MedAxiom’s annual survey. Pay and pay cuts varied greatly depending on subspecialty, employment model and region.

GAO: Few strategies to prevent heart disease provide cost savings

The U.S. Government Accountability Office (GAO) ruled that a number of treatments to prevent cardiovascular disease were either not cost effective or offered no cost savings in a report released Aug. 11.

Pay-for-performance model sputters over long term

A pay-for-performance model in England failed to show much sustained improvement in 30-day mortality for heart failure (HF) and acute MI (AMI), in spite of incentives and penalties, according to a study published online Aug. 7 in the New England Journal of Medicine.

CMS approves CardioMEMS, MitraClip for add-on payments

The Centers for Medicare & Medicaid Services (CMS) agreed to provide some reimbursement for the CardioMEMS heart failure and MitraClip valve devices beginning in fiscal year 2015.

Project lowers costs while improving statin, beta-blocker adherence

A Pennsylvania pharmacy-based intervention program could help patients and insurers alike save money and live healthier lives, according to a study published in the August issue of Health Affairs.