Health Care Policy: Let’s Work Together to Make a Difference! July 29, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Health Policy.Tags: Healthcare reform, Reimbursement
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Recent changes in U.S. health care policy and reimbursement will greatly affect how we deliver care to patients with arrhythmia disorders. The Heart Rhythm Society (HRS) maintains a strong voice in Washington, D.C., with advocacy efforts focusing on issues of critical importance to heart rhythm specialists. Our goal is to help promote a stronger health care system that provides patients with the care they need, when they need it. We recognize that the needs of health care specialists may differ from those of general practitioners when it comes to caring for patients with complex heart rhythm disorders, and that the care of these patients requires a “team approach.” (more…)
CVRP: Identifying Quality in Cardiovascular Care May 28, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Health Policy.Tags: CVRP, Practice management, Quality & outcomes
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As health care evolves from a system based on “volume” to one based on “value,” practices will need a mechanism to show their commitment to continuous quality improvement.
How do you integrate quality into your practice?
To address this question, the Heart Rhythm Society is collaborating with cardiovascular medical societies to develop Cardiovascular Practice Recognition Program (CVRP).
The CVRP is designed to:
- Establish relevant goals for cardiovascular specialists and their practices;
- Provide a road map to guide performance improvement strategies; and
- Create standardization by creating a methodology for how cardiovascular practices are assessed and recognized.
CVRP will promote quality improvement by raising the performance of all providers and enhancing access to high-quality cardiovascular care. CVRP will apply performance measures with scientific validity developed through a recognized development and endorsement process. CVRP assessment, recognition, and reporting will occur at the practice level, and all individual physicians within the practice will be included in the practice assessment. Individual practices will receive feedback to encourage further performance improvement.
More information about the CVRP can be found at:
Performance Measures: Defining Our Terms May 3, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Health Policy.Tags: Healthcare reform, Quality & outcomes, Reimbursement
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Public and private payers are moving away from fee-for-service models and toward value-based purchasing models to reimburse physicians, hospitals, and other health care professionals. With the goal to create incentives to deliver higher quality care and lower overall costs, providers are increasingly being held accountable to quality standards and performance measures. (more…)
What is Quality Care? April 6, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Health Policy.Tags: Quality & outcomes
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What is the definition of “quality care?” According to the Institute of Medicine, “quality care” can be defined as the degree to which health care services for individuals and for populations increase the likelihood of desired health care outcomes and are consistent with current professional knowledge. The key dimensions of “quality” measurement should include consideration of safety, timeliness, effectiveness (i.e., evidence-based medicine), efficiency, equity, and patient-centeredness. (more…)
ICD Shocks and Mortality: “The Chicken or the Egg?” March 8, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Scientific Sessions.Tags: Antitachycardia pacing, ICD
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Do implantable cardioverter defibrillator (ICD) shocks increase mortality?
There is now some data to suggest that shocks are associated with increased mortality. Is this because “shocks are bad,” or are these shocks just markers for the severity of underlying heart disease? In addition, can we infer that “painless” therapy using antitachycardia pacing will be beneficial by reducing shocks? (more…)
How do we Define a High Quality Electrophysiologist? March 3, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Health Policy.Tags: CVRP, Quality & outcomes, Reimbursement
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The current practice environment is rapidly changing for all cardiovascular practitioners, including electrophysiologists, and these changes affect reimbursement for health care delivery.
As we move away from a fee-for-service to a pay-for-performance model of reimbursement, public and private payers are motivated to improve quality while controlling costs. To this end, many payers are developing mechanisms to identify quality physicians through specialty designation programs or tiered networks. (more…)
Contemporary ICD Therapy Discussions at Heart Rhythm 2010 February 25, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Scientific Sessions.Tags: AF, Atrial fibrillation, Defibrillation, ICD, Implantable cardioverter defibrillator
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The Heart Rhythm Society’s 2010 Scientific Sessions will present exciting discussions on state-of-the-art arrhythmia management and device therapy, including highlights on controversial topics with emphasis on quality-related issues.
Featured topics include:
- Programming Devices to Optimize Patient Outcomes
- Minimizing and Managing Device Complications
- Risk Stratification for ICD Implantation and Non-Conventional Indications
- Lead extraction in 2010
- Implantable Device Therapy for Atrial Fibrillation
- Pacing Lead Positioning and Simplifying Implantable Lead Systems (more…)
Sudden Cardiac Death Risk Stratification: Are We Making Progress? February 18, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Scientific Sessions.Tags: ICD, Implantable cardioverter defibrillator, Risk stratification, SCD, Sudden Cardiac Death
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Are we making any headway in the evaluation and treatment of sudden cardiac death?
Up to now, indications for implantable cardioverter defibrillators (ICDs) and risk stratification criteria have been based primarily on left ventricular function. Enrollment criteria in the major clinical trials evaluating the benefit of prophylactic ICD therapy have used left ventricular ejection fraction (LVEF) criteria of ≤30 to 40% as requisites for enrollment. However, most individuals who die suddenly in the population have an LVEF of >40%. In addition, many patients who receive ICDs based on current eligibility criteria may not receive appropriate ICD therapy for several years of follow-up post-implantation. (more…)
The Totally Subcutaneous ICD System: Hype or Hope? February 11, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Scientific Sessions.Tags: ICD, Implantable cardioverter defibrillator, Leads
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The “weakest link” of the implantable cardioverter defibrillator (ICD) system has been demonstrated to be the endocardial lead system. These leads require specialized training and skill to implant.
What if there was no need for an endovascular lead? Perhaps systems might last longer and more physicians would be able to perform the procedure, potentially allowing more patients to receive these life-saving devices.
On the other hand, a “totally subcutaneous” ICD lead system still includes a “lead,” which is implanted underneath the skin. In fact, it is unclear whether this lead system, which is closer to the skin, would withstand trauma and if it would truly “last longer” than current transvenous systems. (more…)
Is Defibrillation Testing Still Necessary At the Time of ICD Implantation? February 5, 2010
Posted by Andrea M. Russo, MD, FACC, FHRS in Scientific Sessions.Tags: ICD, Ventricular fibrillation, VF
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With modern Implantable Cardioverter Defibrillator (ICD) technology, should we really still be doing defibrillation testing at the time of initial ICD implantation?
There is clearly a small, but real mortality rate related to the induction of ventricular fibrillation (VF), not to mention other potential complications such as stroke related to defibrillation testing. In addition, this testing adds to the cost of the procedure, which is an important concern. (more…)