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Healthcare Economics & Policy

 

A $14 million price tag isn’t the only thing standing between cardiac patients and cholesterol-lowering PCSK9 inhibitors anymore—access to the drugs could be further blocked by insurance companies, according to a study published in Circulation: Cardiovascular Quality and Outcomes this week.

The new voluntary bundled payment model announced by CMS on Jan. 9 offers payment for 32 clinical episodes, including several of the cardiovascular variety.

Royal Philips announced the relocation of its North American headquarters in Massachusetts from Andover to Cambridge in 2020. The new location, including a 243,000-square-foot facility, will house 2,000 employees, while 300 ultrasound system manufacturing positions will stay in Andover, according to the Boston Globe.

CMS is on the verge of rescinding a policy that has for years barred heart patients from MRI coverage if they had an implanted pacemaker or cardioverter defibrillator.

Neighborhood characteristics—not just individual socioeconomic standing—could have a significant impact on the cardiovascular health of a community and its residents, reports a study published this week in Circulation: Cardiovascular Quality and Outcomes.

 

Recent Headlines

Physicians weigh in on extent, causes of overtreatment

Most doctors in the United States believe overtreatment is common and could be driven by fear of litigation, patient pressure and personal profit.

More medical students are graduating debt free

About 10 percent more students graduated medical school debt-free in 2016 than in 2010, despite lower scholarship funding, suggesting a higher concentration of students from wealthy backgrounds.

Anthem covers members for noninvasive CAD treatment

A noninvasive technology used to diagnose and treat individuals with suspected coronary artery disease (CAD) is now available to patients covered by Anthem Blue Cross Blue Shield, Blue Shield of California and Blue Cross and Blue Shield of Alabama.

Excessive carbs—not fats—pose greatest dietary risk

Researchers at the European Society of Cardiology Congress are urging a rethink of global dietary guidelines in light of new data.

Prediction model underestimates CV risk in disadvantaged neighborhoods

A widely accepted model systematically underpredicts major atherosclerotic cardiovascular disease (ASCVD) risk in disadvantaged communities, according to a new study in Annals of Internal Medicine.

Unbundling bundles

Unless you were lucky enough to be on an extended summer vacation, you know that CMS proposed to halt bundled payment programs for Episode Payment Models (EPMs) for MI and bypass surgery and the Cardiac Rehabilitation Incentive (CRI) payment model. (Public comment on the changes can be made through October 16th.)

Evolocumab therapy not cost-effective in treating atherosclerotic CVD

The wholesale list price of evolocumab would need to be slashed by roughly one-third—from $14,253 to $9,669—for the cholesterol-lowering drug to meet generally accepted cost-effectiveness standards for treating patients with atherosclerotic cardiovascular disease (ASCVD), according to new research.

ACC promises to work on APM opportunities after proposed cancellation of cardiac bundles

CMS confirmed Tuesday it has proposed to cancel two mandatory bundled payment programs, Episode Payment Models (EPMs) and the Cardiac Rehabilitation Incentive (CRI) payment model, closing a path for cardiologists to qualify for the 5 percent bonus in the Advanced Alternative Payment Models (AAPMs) payment track.

AHA releases new CPR training requirements for 2019

On. Aug. 15, the American Heart Association (AHA) announced CPR training courses will require use of an instrumented directive feedback device, effective Jan. 39, 2019. Using the devices, students receive audiovisual evaluation and corrective instruction on chest compression rate, depth and proper hand placement.

JACC's Walsh: MACRA means working smarter, more efficiently

MACRA—the Medicare Access and CHIP Reauthorization Act of 2015—will have profound impact on the healthcare industry as a whole. In the Aug. 14 “Leadership Page” of the Journal of the American College of Cardiology, ACC President Mary Norine Walsh, MD, details her views on just how cardiologists and practice administrators can prepare themselves.

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