CardioExchange Archive

March 1st, 2012

The Growing Number of Observation Stays: How Do You Decide?

Harlan M. Krumholz, MD, SM

The number of observation stays are growing in this country, in part as a response to Medicare audits that are disallowing admissions for some patients – and maybe in part to reduce crowding in the Emergency Medicine Department. The problem is that criteria are not clear, so there is likely a lot of variability across […]

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February 3rd, 2012

CMS Releases Details of Proposed National Coverage for TAVR

Larry Husten, PHD

On Thursday the Centers for Medicare & Medicaid Services (CMS) released a memo containing details of its proposed Medicare coverage for transcatheter aortic valve replacement (TAVR). The memo is a response to a formal request for national coverage determination (NCD) from the Society of Thoracic Surgeons (STS) and the American College of Cardiology (ACC). The memo will be open […]

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September 20th, 2011

Significant Declines Observed in Cardiovascular Procedures Performed in Hospitals

Larry Husten, PHD

More evidence is starting to emerge that the overall volume of cardiovascular procedures in U.S. hospitals is in decline. The trend should come as no surprise to those who have been following news about cardiovascular medicine in recent years, as the field has been repeatedly struck by debate, scandal, and controversy related to the potential […]

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August 5th, 2011

USA Today Finds Disparity Between Hospital Performance and Public Perception

Larry Husten, PHD

Patients may think they’re going to a high-quality hospital when in fact they’re not, according to an analysis of Medicare data appearing in USA Today, by reporters Steve Sternberg and Christopher Schnaars. The USA Today website also contains an interactive graphic with a user-friendly interface, to help readers compare hospital death rates and readmission rates […]

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April 26th, 2011

Drug-Eluting Stents Add Nearly $1.6 Billion per Year to Medicare Costs

Larry Husten, PHD

Drug-eluting stents (DESs) cost Medicare an additional $1.57 billion per year, according to a study published online in the Archives of Internal Medicine. Using a random sample of Medicare beneficiaries, Peter Groeneveld and colleagues compared annual costs for patients with coronary artery disease in 2002 (the year before DESs were introduced) with costs from 2002 […]

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January 6th, 2011

The Shame of Removing Reimbursement for End-of-Life Discussions from Health Care Reform

Barry M. Massie, BA (Harvard), MD (Columbia P&S)

My recent postings have been about heart failure mortality statistics. Dry stuff! It’s not that I am fixated on death, but yesterday, I learned that CMS (Medicare) has decided not to pay for discussions with patients about prognosis and planning end of life care. Reimbursement for such discussions was a key aspect of the health care […]

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October 12th, 2010

Heart Failure and Resource Use at the End of the Road

Larry Husten, PHD

Two studies of heart failure populations — one conducted in the U.S. and one in Canada —  shed light on patterns of resource use in the last 6 months of life. Both studies appear in the Archives of Internal Medicine. Kathleen Unroe and colleagues retrospectively analyzed resource use in a cohort of nearly 230,000 U.S. Medicare […]

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