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Hospitals to Lose an Average $10,000 to $20,000 per Case on Common Cardiovascular Procedures Under Medicare's Value-based Purchasing Program

Low incidence of hospital-acquired conditions to minimize financial impact; greatest financial risk to hospitals with high incidence of mediastinitis

and pressure ulcers

NEW ORLEANS, Nov. 12 /PRNewswire/ -- The initial financial impact of Medicare's new Value-based Purchasing initiative, which took effect October 1, 2008, will be relatively small for U.S. hospitals in regard to hospital-acquired conditions (HAC) for five of the most common cardiovascular procedures. That is according to research presented this week by Dr. Matthew Reynolds of the Harvard Clinical Research Institute at the American Heart Association's Scientific Sessions 2008 in New Orleans. For most of the 11 HACs for which Medicare will no longer assign higher reimbursement rates, the average loss per case will be between $10,000 and $20,000. However, losses are projected to be higher for two of the HACs when associated with cardiac surgical procedures: mediastinitis (a deep infection of the chest) at nearly $70,000 and pressure ulcers at more than $40,000. Pressure ulcers also had the highest incremental length of stay for all five procedures studied, adding on average 10 to nearly 18 days.

The good news for cardiac patients is that the incidence rate was less than 0.1% for six of the 11 HACs studied and less than 1 percent for four others. The exception was "falls for pacemaker implant patients," which had an observed incidence rate that exceeded 2 percent during fiscal year 2006.

The research, funded and conducted by Cardiac Data Solutions, studied data on Medicare beneficiaries who underwent one of the following procedures between October 1, 2005 and September 30, 2006:

-- isolated coronary artery bypass surgery (CABG)

-- any cardiac valve surgery

-- percutaneous coronary intervention (PCI)

-- an implantable cardioverter defibrillator (ICD) implant

-- a permanent pacemaker (PPM) implant

The study looked at differences in hospital costs and length of stay for Medicare patients who did and did not experience one of the 11 HACs for which the Centers for Medicare and Medicaid Services (CMS) no longer assigns a higher paying diagnostic-related group (DRG) when the condition is not present upon admission.

"The study results were generally good news for U.S. hospitals, with both the HAC incidence rates and expected incremental costs relatively low in most cases," said April Simon, RN, MSN, president of Cardiac Data Solutions and one of the researchers. "The exception could be hospitals with disproportionate rates of HACs no longer being covered at a higher rate by CMS. The study also suggests that all hospitals should pay particular attention to incidence rates for pressure ulcers, falls, and mediastinitis associated with cardiovascular procedures and focus efforts as needed to improve quality in these areas."

Other researchers included: Phillip P. Brown, cardiovascular surgeon (retired) and past chairman, Department of Surgery, Centennial Medical Center; David J. Cohen, MD, interventional cardiologist and director, Cardiovascular Research, Mid America Heart Institute, St. Luke's Hospital; Aaron Kugelmass, MD, director of Cardiac Catheterization at Henry Ford Hospital; Matthew R. Reynolds, MD, electrophysiologist and director, Economics and Quality of Life Assessment Group, Harvard Clinical Research Institute; and Steven D. Culler, PhD, associate professor, Rollins School of Public Health, Emory University.

About Cardiac Data Solutions, Inc. (CDS)

Founded in 1999, Cardiac Data Solutions, Inc. (CDS) provides consultation services, data analysis, clinical benchmarks, management tools, research support services and leadership training to hospitals, physicians, payors, manufacturers and the financial community. CDS is focused solely on the cardiovascular market with the primary mission of supporting and improving clinical and business decisions to improve the quality of patient care. Using proprietary data analysis tools with comprehensive and current data on clinical outcomes, CDS helps identify opportunities for improvement and develops evidence-based strategies to achieve them. For more information, visit


Karen Conway



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SOURCE Cardiac Data Solutions, Inc.
Copyright©2008 PR Newswire.
All rights reserved

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