FRANKLIN, Tenn., Nov. 10, 2011 /PRNewswire/ -- MedSolutions, a leading provider of quality-driven medical cost management services, today announced the launch of its Implantable Cardioverter Defibrillator (ICD) Surgery Management Program, which uses evidence-based guidelines to ensure the clinical appropriateness of ICD and CRT-D (cardiac resynchronization therapy defibrillator) implantation and directs members to the most qualified physicians and facilities.
With the cost of each ICD/CRT-D procedure averaging $34,000(1) and 157,082 procedures being performed annually,(2) the ICD/CRT-D market represents approximately $5.3 billion in cost per year in the United States. In addition, the estimated annual growth rate of ICD/CRT-D procedures is 11% to 14% respectively.(3)
While clinical guidelines dictate waiting three months after diagnosis of heart failure and at least 40 days after a heart attack before ICD/CRT-D implantation, many physicians take a more aggressive approach to surgery. Earlier implantation has not been shown to benefit patients and, in some cases, the physicians or facilities providing the surgery may lack knowledge of evidence-based guidelines for ICD implants.(4)
Studies have shown that as many as 22.5% of ICD/CRT-D surgeries fail to meet established clinical guidelines, putting patients at greater risk for serious complications, including cardiac perforation, infection, and even death. According to one recent study, patients who received an ICD despite failing to meet evidence-based guidelines had "significantly higher" risks of post-procedure complications and in-hospital death, as well as longer hospital stays, than individuals who met evidence-based criteria.(5)
"ICD surgery is an effective and beneficial treatment for tens of thousands of patients, but it can be extremely harmful when performed outside of accepted guidelines," said Gregg Allen, M.D., chief medical officer of MedSolutions. "Not only do unnecessary ICD surgeries put patients at risk for a number of life-threatening issues, they also represent avoidable health care costs of up to $36,000 per procedure,(6) not including co-pays or additional costs to treat adverse outcomes."
MedSolutions' Implantable Cardioverter Defibrillator Surgery Management program uses evidence-based clinical guidelines built upon the latest guidelines from the American College of Cardiology, American Heart Association, and Heart Rhythm Society and provides a dedicated cardiac queue, including cardiologists and nurses experienced with the complexities of cardiac care, to determine whether ICD implantations are clinically appropriate.
"By reducing unnecessary and inappropriate ICD/CRT-D surgeries and ensuring that patients who require surgery are directed to experienced physicians and quality facilities, our program helps improve health outcomes while limiting unnecessary costs associated with the procedure," Dr. Allen said. "As a result, members experience improved outcomes and payors can reduce total claims costs related to cardiac implantables by 10% to 15%."(7)
Using independently validated savings methodologies, MedSolutions specializes in quality-driven intelligent cost management of medical services for commercial, Medicare, and Medicaid payors. The company maintains management contracts for more than 33 million individuals nationwide. Using robust data, predictive intelligence technology and evidence-based clinical expertise, the company's innovative solutions extend beyond Radiology Management to other areas of medical specialty, including Oncology, Cardiac Imaging, Sleep, Ultrasound, Lumbar Spine Surgery, and MedSolutions' groundbreaking Premerus® Diagnostic Accuracy program – the nation's first solution for reducing diagnostic error rates to improve the quality and cost of care. MedSolutions has been recognized for outstanding customer service and effective call center management by the International Customer Management Institute and for four consecutive years by the prestigious J.D. Power and Associates Award. Visit www.medsolutions.com.
Contact: Rebecca Kirkham
(1) Boston Scientific. (July 30, 2011). "CMS Issues 2011 Final Inpatient Rule: CMS Reimbursement Update."
(2) Hammill, et al. (September 2010). "Review of the Registry's Fourth Year, Incorporating Lead Data and Pediatric ICD Procedures, and Use as a National Performance Measure." National ICD Registry Annual Report 2009.
(3) Sg2. (2011). "Impact of Change" v. 10.0, NIS Analysis
(4) Al-Khatib, et al. (January 5, 2011). "Non-Evidence-Based ICD Implantations in the United States." JAMA 305.1:43-49,26 http://jama.ama-assn.org/content/305/1/43.full
(5) Ibid, 4
(6) Boston Strategic Partners. (September 2011) "Cardiac Procedure Cost Assessment."
(7) MedSolutions Data on File
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