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The recently reported CANTOS trial represents an enormously important development in cardiovascular medicine. For the first time, an anti-inflammatory drug (canakinumab) given by injection every three months has been shown to reduce morbidity and mortality. Trial entry criteria required a hsCRP level >2 mg/L and stable coronary heart disease. The 150-mg dose reduced the risk of nonfatal myocardial infarction, stroke and cardiovascular death by 15 percent with no effect on lipids. These benefits were observed in patients already treated with the best available therapies, including high-dose statins and antiplatelet drugs. The importance of these findings extends far beyond the CANTOS trial. Now that we know that treating inflammation can reduce cardiovascular morbidity and mortality, the search for other anti-inflammatory regimens can proceed with the high likelihood of successful clinical trials.

This has been such an exciting time in cardiology—although the lens we use is often cloudy. Why? Because the pace of change is truly unparalleled. From massive changes in the physician fee schedule resulting in a rapid migration to employment to a total transformation in cardiovascular care delivery models, our practices are not what they were a decade ago. Cardiovascular service lines, dyad leadership and payment for quality and patient outcomes were unheard of in 2007. Yet I find our world invigorating and inspiring. We have successfully reduced mortality related to cardiac events!

With physicians and administrators ever more focused on high-quality medicine and the financial bottom line, what trends and strategies are shaping the future of the cardiovascular service line? Let’s take a look at the future forecast through the expert eyes of Brian Contos, an executive director of The Advisory Board Company. Is your program poised to take advantage of changing market dynamics such as outpatient care, reimbursement and payment policies? And what about implantables, MACRA patient-focused care and interventional procedures like Protected PCI?

As risk-sharing agreements become more common, hospitals and physicians are focusing on teamwork and attention to metrics.  

Questions have swirled around the value of percutaneous coronary intervention (PCI) for patients whose quality of life has suffered from chronic total occlusion (CTO). Inevitably, another issue has arisen: which cath labs and operators should be undertaking these difficult and costly procedures?

The availability of a specialty drug doesn’t guarantee its accessibility, as cardiologists who try to prescribe PCSK9 inhibitors to their patients are learning. Insurers’ requirements for prior authorizations can create formidable barriers, but some providers have found ways to surmount them.

Some hospital systems are considering offering integrated vein care centers. One of the challenges they face is uncertainty about reimbursement.

With the passage of MACRA and introduction of new reimbursement models, hospitals are analyzing the costs and benefits of sending patients to skilled nursing facilities (SNFs).

Pediatric cardiologists say they can use telemedicine to improve patient care and ease the burden on patients’ families. But with the costs of these programs stretching into the hundreds of thousands, and a patchwork of reimbursement and regulations to contend with, what does it take to find success with pediatric telecardiology?

Cardiology’s Shark Tank will be back for its fourth year when TCT convenes Oct. 29-Nov. 2, in Denver. Program Director Juan F. Granada, MD, shares insights from the conference’s innovation competition.

The business of cardiology was at the forefront of discussion at the Society for Cardiovascular Angiography and Interventions (SCAI) Cath Lab Leadership Boot Camp in May. Speakers focused on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), bundled payment models and value-based reimbursement. Here are a few of the lessons attendees took back to their practices.

Recent medical group compensation and productivity data surveys fielded by AMGA suggest trends for practices to watch.

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