This article is more than 5 years old. Information may no longer be current.
PCI vs. non-PCI hospitals modestly more expensive for acute MI care
Click Here to Manage Email Alerts
Although increased PCI and CABG rates were reported for PCI hospitals in a recent study, these hospitals were only $627 costlier than non-PCI hospitals for the treatment of patients with acute MI.
“In this study of Medicare administrative claims, we found that PCI hospitals were associated with slightly higher costs for an episode-of-care for patients with [acute] MI when compared with non-PCI hospitals,” the researchers wrote. “The difference is fairly modest — [roughly] $600 for a 30-day period — and the percentage difference in cost is small, but when spread over the hundreds of thousands of beneficiaries with [acute] MI each year, these cost differences could be meaningful.”
For the study, researchers culled all 2008 acute MI admissions of Medicare fee-for-service beneficiaries, and classified hospitals as either PCI- or non-PCI-capable based on the hospitals’ 2007 PCI performance. They added all payments, including to hospitals other than the admitting hospital, from admission through 30 days after admission, and determined risk-standardized payment for PCI and non-PCI hospitals, adjusting for patient demographics and clinical characteristics.
At 30 days, PCI hospitals demonstrated a higher mean risk-standardized payment than non-PCI hospitals ($20,340 vs. $19,713; P<.001).
Also significantly increased for patients who presented at PCI hospitals were rates of PCI (39.2% vs. 13.2%; P<.001) and CABG (9.5% vs. 4.4%; P<.001) during index admissions. Conversely, there were lower rates of transfer (2.2% vs. 25.4%; P<.001) and revascularization within 30 days (0.15% vs. 0.27%; P<.0001) among those presenting to PCI hospitals.
“Our findings suggest that sending all patients directly to PCI hospitals may slightly increase payments for Medicare patients admitted with [acute] MI, and likely to be associated with increased PCI usage,” the researchers wrote. “Because patients who present with [acute] MI may benefit from more rapid access to PCI, and in light of our findings that payments to PCI vs. non-PCI hospitals do not differ dramatically, regionalization of [acute] MI care may provide an efficient option for the treatment of these patients.”
Disclosure: Researchers report financial disclosures with CMS, Fair Health, Medtronic and United Healthcare.
Click Here to Manage Email Alerts