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IVC filter retrieval costly to hospitals
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HOLLYWOOD, Fla. — Costs of inferior vena cava filter removal vary greatly, and almost all centers that perform them have a negative contribution margin, according to data presented at the International Symposium on Endovascular Therapy.
Prompt retrieval of IVC filters is associated with reduced complications, but retrieval rates are low, Ido Weinberg, MD, medical director of VasCore at Massachusetts General Hospital and assistant professor of medicine at Harvard Medical School, said during a presentation here.
According to Medicare data, in 2016, there were 8,053 IVC filter retrievals in the Medicare population, with total allowed charges of $3.85 million and total payments of $2.98 million, Weinberg said.
To further shed light on IVC filter retrieval costs, Weinberg and colleagues including Jay Giri, MD, John Kaufman, MD, and Eric Secemsky, MD, analyzed hospital charges and payments associated with IVC filter retrieval procedures in the Medicare population during 2016. The researchers used data from the top 105 centers by volume and estimated hospital costs using hospital-specific cost-to-charge ratios.
Among the 105 centers studied, median number of retrievals in 2016 was 19 (interquartile range, 15-24), Weinberg said.
The mean cost of retrieval was $3,624.82 (range, $1,496-$7,352.65) and the mean reimbursement was $1,919.11 (range, $1,563.60-$2,739.37), according to the researchers.
Weinberg said the variance was much higher for cost than it was for reimbursement (P < .0001).
The biggest factor determining total cost was operating room cost, which averaged $1,538.04 and ranged from $0 to $5,577.98, he said.
Regardless of procedure volume, IVC filter retrieval procedures were associated with a negative contribution margin in almost all centers studied, with an average contribution margin of –$1,636.67, he said.
“There is an almost uniform negative contribution margin at all variations of costs and reimbursements,” Weinberg, who is a Cardiology Today Next Gen Innovator, said during the presentation. “Cost is mainly driven by operating room costs, possibly reflecting the influence of more complex retrievals. As IVC filter retrieval presents complications, but it is costly, other incentives may be needed to increase IVC filter retrieval rates.” – by Erik Swain
Reference:
Weinberg I, et al. Clot management and venous interventions. Presented at: the International Symposium on Endovascular Therapy (ISET); Jan. 27-30, 2019; Hollywood, Fla.
For more information:
Ido Weinberg, MD, can be reached on Twitter at @angiologist.
Disclosure: Weinberg reports he serves on the scientific advisory board for Novate Medical and is a noncompensated advisor for BTG.