Hospitals to Lose an Average $10,000 to $20,000 per Case on Common Cardiovascular Procedures Under Medicare's Value-based Purchasi...( Low incidence of hospital-acquired co...),Health

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
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