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Healthcare Economics

 - Money in the Pocket

At least 200 cardiologists received $1 million or more in Medicare reimbursement in 2012, according to data made public April 9 by the Centers for Medicare & Medicaid Services. The top earner’s reimbursement exceeded $18 million.

 - seniors

The Centers for Medicare & Medicaid Services (CMS) may begin posting information about physician payments as early as April 9, a move the government says will facilitate transparency and medical groups charge will foster confusion. 

 - Downward Trend

Citing echocardiograms and nuclear cardiology as examples of distorted incentives, the Medicare Payment Advisory Commission (MedPac) recommends aligning outpatient prospective payment rates to physician office rates. The change could trim $264 off hospital payments for certain echo procedures.

 - Money_chart

WASHINGTON, D.C.—Despite access to care, a study of Medicare beneficiaries who underwent stress echocardiography found race significantly impacts downstream two-year cardiac costs, with non-white patients having significantly lower costs, according to a poster presentation at the American College of Cardiology (ACC) scientific session.

 - Congress, House, Senate

The American College of Cardiology said Congress squandered an opportunity to provide certainty over Medicare when it failed to permanently repeal the sustainable growth rate (SGR) formula.


More Stories

The SGR countdown

Twenty-five. That is how many days remain before the patch on the sustainable growth rate (SGR) formula becomes unglued if Congress fails to approve a repeal.

Obesity takes heavy toll on medical costs

Medical costs were 22 percent higher for overweight patients who presented at an emergency department with chest complaints compared with normal weight patients, and 41 percent higher for morbidly obese patients, researchers reported online March 4 in Circulation: Cardiovascular Quality and Outcomes. The findings also hinted at possible unnecessary imaging in the morbidly obese.

CBO: Repealing SGR may cost additional $60B over 5 years

The Congressional Budget Office (CBO) estimated that a proposed bill to repeal the sustainable growth rate (SGR) formula and adjust Medicare payments to providers would increase spending by about $60 billion between 2014 and 2019 if enacted. Between 2014 and 2024, that amount would increase to $138 billion.

Costs vary widely across hospitals for congenital heart operations

Costs for congenital heart surgery vary across hospitals, with complications and length of stay contributing to more than a quarter of the variation, researchers reported in the March issue of Pediatrics.

CMS will cover cardiac rehab for HF patients

The Centers for Medicare & Medicaid Services (CMS) expanded its coverage for cardiac rehabilitation services to include patients with chronic heart failure (HF) after determining that rehab is safe and effective.

Genotyping makes some antiplatelet therapy more cost-effective

Tailoring antiplatelet therapy based on a person’s genetic information may be a cost-effective strategy when using prasugrel and ticagrelor after PCI, a study published online Feb. 17 in Annals of Internal Medicine found. In addition, the study found that ticagrelor may be cost-effective for all patients without the need for genotyping.

Survey: AdvaMed members feel pinch of medical device tax

A survey of member companies in the Advanced Medical Technology Association (AdvaMed) found that the companies are reporting the first year of the medical device excise tax resulted in a loss of jobs and restrained research and development.

OIG targets cardiac caths, biopsies for review

The Office of Inspector General (OIG) added a nationwide review of cardiac catheterizations and heart biopsies to its 2014 work plan. The work plan spells out federal priorities with a focus on reducing waste and fraud in Medicare and Medicaid programs.

Corporate coups

This week two corporations, CVS Caremark and AT&T, made announcements that likely will help boost their images with consumers.

FDA rulemaking process lacks transparency, efficiency

The FDA takes an average of 7.3 years to finalize rules that determine its regulation process, a study published in the February issue of Health Affairs found. Rules associated with cost-benefit analyses take the longest to review, and longer review times often mean the final rules are less stringent than the ones proposed initially.

Longer wait times indicate increased demand for cardiologists

In yet another indicator that demand for cardiologists is on the rise, a survey of patient wait times for five specialties in 15 major metropolitan markets reported an uptick for cardiology in 2013.

Differences between high- and low-price hospitals demystified; radical changes coming?

Intense and increasing pressure to control growth in private health insurance premiums may lead to radical approaches like state-based rate setting or restrictions on contracting arrangements between hospitals and health plans, according to a study published online Jan. 29 by Health Affairs.

Mortality lower with VADs, but readmissions still high

Ventricular assist devices (VADs) may lower the risk of mortality, but not readmission, according to a study published online Jan. 29 in the Journal of the American College of Cardiology.

Multiple CPR attempts costlier in terms of dollars & survival

Hospitalized patients who receive cardiopulmonary resuscitation (CPR) multiple times are demographically different from their hospitalized counterparts who receive CPR only once, according to a study published in the January issue of the Journal of Hospital Medicine. They tend to be younger, nonwhite and treated in non-teaching hospitals. Survival is also poorer and hospitalizations tend to be higher.

pVAD safer, more cost-effective than surgical alternatives

Compared with traditional surgical hemodynamic support measures, percutaneous cardiac assist devices (pVADs) are less invasive and result in better outcomes, shorter lengths of stay, better survival rates and lower cost in patients with cardiogenic shock, according to a study published online Jan. 13 in Catheterization and Cardiovascular Interventions.

Hold the needle: Multistage screening as good as lab testing

Think twice before requesting a cholesterol lab test to assess a patient’s risk of cardiovascular disease. A study published online Jan. 14 in Circulation: Cardiovascular Quality and Outcomes determined that doctors could obtain comparable results faster and at less cost using a multistage screening strategy.

Appealing RAC decision? Wait in line

Hospitals and physicians challenging auditor decisions on Medicare reimbursement may have a long wait to have their day in court. The federal office that handles appeals is warning providers that it has temporarily suspended assignment of most new requests in an effort to whittle down its 16-month wait time.

Strategies to up thrombolysis rates provide cost savings

Any strategy that raised thrombolysis rates, including increased use of imaging, ultimately would pay for itself through cost savings and improved quality of life for stroke patients, an analysis published online Jan. 2 in Stroke concluded.


Cardiology, radiology specialists still command top pay

Cardiology and radiology physicians continued to earn some of the highest levels of compensation in 2012 compared with other specialties despite some categories experiencing a year-to-year decline.

Healthcare executives optimistic about Affordable Care Act

Despite the largely unfavorable view of the Affordable Care Act and its potential impact on the U.S. healthcare system held by the majority of the public and many politicians, a blog published online in Health Affairs argued that healthcare leaders do not share such a pessimistic outlook. A survey found that 65 percent of executives believe the healthcare system will improve because of the new law.