"What I really want is a government solution"

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Kaitlyn Dmyterko, senior writer

“What I really need in a world of revolution. What I really want is a government solution,” sang Peter Frampton in the song Solution. Likewise, this week in cardiology, we find ourselves searching for a solution to many unanswered questions, such as how can we prevent complications and reduce medical errors and at the same time cut costs?

One of our top stories this week showed that medical errors—infection and device complication, among others—cost the U.S. $17 billion in 2008 alone, 0.72 percent of the $2.39 trillion spent on healthcare that year.

Additionally, a study in Circulation showed that a large number of patients undergoing ICD replacement have complications that can have devastating results, including death. Infection and reoperation were most harmful to patients and increased the patient’s risk of mortality by 8.7 percent at both 90 and 180 days.

So, what are some solutions that can reduce these costs and at the same time improve quality?

At the annual meeting of the American College of Cardiovascular Administrators (ACCA) last week, a practice in Lincoln, Neb. shared that proper documentation uncovered $1.5 million in additional annual revenue. In addition to this revenue, documentation also better captured patients’ acuity and severity of disease. The staff at BryanLGH Heart Institute found that re-training staff in proper documentation also can increase the case-mix index and improve workflow.

Additionally at ACCA, Jack Lewin, MD, CEO of the American College of Cardiology, offered that getting involved in data registries like the PINNACLE registry that capture quality and outcomes data can improve quality reporting while at the same time reduce costs. However, he said that many are hesitant to participate in these types of registries because incentives are so low ($8,000-$9,000).

As for an overall government solution, Phillip L. Ronning, president of Ronning Healthcare Solutions, said that accountable care organizations ( ACOs) while still undefined, may help improve organizational culture, align incentives and enhance the role of the primary care physicians.

ACOs will create a paradigm shift within healthcare that will help to solve problems like medical waste, overuse of specialists and the fact that patients often are not currently getting what they pay for, according to Ronning.

The shift to ACOs will help curb overuse and misuse while encouraging accountability and responsibility; however, whether ACOs will provide a one-stop shop for healthcare reform remains to be seen.

How are you prepping to become accountable? Let us know.

Kaitlyn Dmyterko

Senior Writer, Cardiovascular Business News