The cost conundrum

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Kaitlyn Dmyterko - Portrait - 160.99 Kb
Kaitlyn Dmyterko, Associate Editor

This week in cardiology it’s all about the Benjamins, or lack thereof. Piggybacking off last week’s topic of healthcare reform, this week the focus is on the future of healthcare and strategies that can help to make it more cost-effective. 

At ACC.12, Cathleen D. Biga, RN, president and CEO of Cardiovascular Management of Illinois, talked about how the fee schedule pains physicians, and has forced many practices to shut their doors and partner with local hospitals. She said that the future of the fee schedule is complex and puzzling, particularly as these reimbursements continue to fade away.

Another issue that cardiologists face is not getting paid up to par for the fee-for-service work they perform, said Gregory S. Thomas, MD, MPH, cardiologist at Mission Internal Medical Group in Mission Viejo, Calif. Despite the pangs of reimbursement cuts, Thomas said that integrating co-management opportunities, collaborating with other medical groups and enhancing clinical research opportunities can help get over these hurdles.

Fredrick A. Masoudi, MD, in the division of cardiology at the University of Colorado in Denver, also touched on the fact that while appropriate use criteria are helpful, they rarely focus on costs. With the nearly 10-fold variation in PCI use across the nation, costs as they stand now in the healthcare system will someday be unsustainable.

How can these problems be rectified?

One option could be the growing use of patient-centered medical homes (PCMHs). A study published in the American Journal of Managed Care showed that use of the medical home can improve patient care and decelerate growing healthcare costs by enhancing care delivery. While return on investment did not reach statistical significance, researchers from Geisinger Health System in Danville, Pa., said that as the use of the technology increases, so will the accrued savings.   

In addition, a report issued by the American Hospital Association (AHA) offered ways that hospital administrators can prep for increasing costs. Some methods, along with cutting costs, are restructuring businesses and service lines and transforming clinical practice. The methods must include financial planning, assessing the local markets, reassessing service lines and better distributing care.

What are you doing in your practice to pinch pennies and improve care? Email me and let me know.

Kaitlyn Dmyterko
Cardiovascular Business, associate editor