Developing a successful EP service line / practice
|
|
- Edwin Dickerson
- 5 years ago
- Views:
Transcription
1 Developing a successful EP service line / practice Steven J. Kalbfleisch, M.D. Medical Director Electrophysiology Laboratory Ross Heart Hospital Wexner Medical Center The Ohio State University Evolution of the Electrophysiologist 70 s Academic Centers HIS Bundle Recorders 90 s The Academic Electrophysiologist 80 s Academic Centers The Electrophysiologist Ablation/ICD The 90 s EP Explosion 90 s Private Practice Tilts Cardioversions Device-ologist Extractor Implanter Blue-Collar Ablation Ablation-ologist Afib Specialist Y2K Devices / extractions Ablations VT Specialist (epicardial space) 1
2 A Full Service EP Service Line What is Mandatory for a Level 3 center Arhythmology Device EP Clinics General vs Specialty Diagnostic EP studies Tilt Table testing Cardioversions, DFT checks Ablations Basic SVT, AF, VT, Epicardial Inpatient Service / Consults CRM device therapy PCMK, ICD, SQ ICD, CRT, LINQ Device clinic Remote monitoring Inpatient management (OR, MRI) Extractions Hospital EP Programs A General Categorization Level 1 Basic Device Therapy (PCMK and ICDs) Just need an OR and a device rep Level 2 Diagnostic EP, simple ablations, CRT therapy The Hospital has to invest in Basic EP equipment Level 3 (A tertiary center program) Complex ablations (AF, VT), extractions Hospital has to buy mapping and extraction equipment. This requires anesthesia and thoracic surgery support / backup 2
3 What you have to address to set up an EP service line Outpatient clinics Inpatient care (post procedure) and consults Device follow-up outpatient and inpatient management EP lab setup Patient flow into the practice What services will take your program to the next level A Research Section (best way to stay current) Advanced Ablation therapy (AF, VT) Hybrid Lab (extractions, LAA device therapy) Collaboration with thoracic surgeon Specialty EP clinics (look for niche opportunities) AARx monitoring clinics (Pharmacy driven) Arrhythmia Genetics (LQT, Brugada, CPVT ) Sarcoid / HCM / ARVD / Adult congenital dz Syncope clinic Outreach sites (clinics, procedures, consults) True Service You need to make it easy to get into your system! 3
4 EP service line value EP generates patient referrals / volume EP physicians do high technical and professional revenue generating procedures EP programs have a large halo effect in the system Recurrent device checks / replacements / revisions / extractions Event / holter monitoring Ablation therapy: Imaging TEE, LA CT, CMR Who is involved in the service line? EP physicians EP Lab nursing and X-Ray techs Outpatient EP clinic nurses Dedicated device nurses EP NPs (inpatient care and outpatient clinics) If you are a solo EP you should request this support EP floor nursing (Dedicated EP floor?) Anesthesia / Thoracic surgery Recovery room staff Pharmacists? A luxury you may not have 4
5 Electrophysiology Lab 2017 Stuff to Buy You probably can t have it all! So you want to Buy an EP lab Room Costs New Build = 2M, Remodel = 1 M Fluoroscopy 750 to 1M 3D Mapping / Ablation system 225 to 300K EP / Hemodynamic recording 150K Stimulator 20K Ancillary equip. (defibs, shields, BP monitor.) 100K Cryo-Ablation console 85K ICE Unit 120K Grand Total. Approx 2.5 to 3M No one cares about the cost until they are told No! 5
6 AF Ablation Programs The most significant reason for EP volume increases over the last decade. In most large EP programs AF ablation accounts for approximately 50% of ablation volume. It is now mandatory to have in almost every reasonably sized EP program. Can now be done safely, effectively and efficiently. It is the straw that stirs the drink. How to Justify an AF Program Guidelines, Contribution Margin, spin off HRS guidelines AF RFA is a class I recommendation for AF therapy after failed medical Rx, class II rec. for first line Rx. It is now a standard of care therapy Every high volume procedure needs to be profitable to survive. No Margin, No Mission. If it contributes on it s own then you can also talk about spin off and halo effects. This is very hard to quantify 6
7 January 8 th 2015 Double Jeopardy Another reason PVI is now mainstream Category Body Check $2000 Question; A treatment for atrial fibrillation is PVI, short for this vein isolation Our Groups Ablation Procedures Basic RFA Afib RFA Total RFA AF Ablation growth limited by availability of resources Lab space and time / Anesthesia / EP Physician time / willingness AF Ablation can become a bit mind numbing sometimes comfortably numbing 7
8 Growth in AF Ablation Industry Estimates 1% Ablated 68,000 Ablations 6% Ablated Asymp. 40% Failed Rx 30% Rx Effective 30% 2013: Ablations Catheter 65,000 Surgical 15, : Industry estimate an Total 80,000 Additional 26% growth 8% Ablated 10% Ablated Bottom Line Currently you could put an AF ablation program almost anywhere and have patient volume Hospital Cost and Margins AF Ablation AF Ablation Medicare 2013 (Catheter) (Surgical) Average Direct Cost $13,589 $29,012 Average Reimbursement $18,504 $47,964 Contribution Margin $4,645 $19,952 The Bottom Line Catheter AF Ablation is a net positive but could be easily become negative with additional direct costs. You need to try to understand and help control costs! The Advisory Board Company 8
9 What do you need to start an AF ablation program Support staff Clinic nurse pre and post patient care / support EP lab staff (nurses and RTs 3 to 4 /case) Advanced EP lab 3D electro-anatomic imaging ICE Multimodality integrated screen viewing Anesthesia for RFA, maybe not for Cryo Imaging support (CT, CMR, echo) Emergency backup Thoracic surgery (fortunately rarely needed now) Dedicated pre and post procedure areas What data should you track at your program Every program needs QA and compliance oversight Mandatory - ACC-NCDR ICD registry participation, LAA closure registry if doing watchman Pacemakers similar info to ICDs AF ablation / Extraction need to document indications, techniques, complications, and outcomes (1 yr for AF) 9
10 How to build patient volume Who are your best referrings? A general cardiologist who is willing to see syncope and Afib patients. A general cardiologist who does basic device work. (You can t stop it, so don t try). ER Doctors (they see PSVT / WPW first) Thoracic surgeons (they also bail you out) Interventional cardiologists willing to look at a monitor (they hate arrhythmias!) Primary care with an interest in cardiology Hospitals / Systems in you region that don t do advanced cardiac care Most important question What does the outreach site want? Procedures (Device and ablation)? Clinic? Inpatient consultation? Procedures are the easiest limited follow up. Just need hospital privileges. Clinic is the hardest requires a support structure (nurse / device) and follow up. Is legally more complex to set up. Do not promise something you can t or don t want to deliver 10
11 Hospital EP Programs A General Categorization Level 1 Basic Device Therapy (PCMK and ICDs) Just need an OR and a device rep Level 2 Diagnostic EP, simple ablations, CRT therapy The Hospital has to invest in Basic EP equipment Level 3 Complex ablations (AF, VT), extractions Hospital has to buy mapping and extraction equipment. This requires anesthesia and thoracic surgery support / backup The ideal outreach site Medium sized hospital 100 to 200 beds i.e. not enough to support and EP doc full time Active cath lab with or without open heart surgery capabilities 2 to 5 cardiologists With an active device follow up clinic with at least 1 device implanting physician, since then they often won t want to hire a full time EP 500 to 1000 cath procedures / yr The 10% Rule Basic EP / ablation, device and referral volumes are each approximately 10% of cath / PCI volume. Procedure only care with same day DC 11
12 How to build a successful EP practice / program How did you get patient referrals? How much of your practice is device vs ablation? Hospital vs outpatient? Do you get / do all the device work or do other CV specialists do some of the work? Was the hospital admin helpful in getting you what you wanted / needed? Who is the most helpful to you in your daily work? What was the easiest thing about building your practice? Hardest? 12
The Role of the Arrhythmia Nurse
The Role of the Arrhythmia Nurse RACHEAL JAMES BHF SUPPORTED ARRHYTHMIA NURSE SPECIALIST UHW The Role of the Arrhythmia Nurse Specialist It is now widely recognised that the skills and expertise that nurses
More informationSIMPLE SOLUTIONS. BIG IMPACT.
SIMPLE SOLUTIONS. BIG IMPACT. SIMPLE SOLUTIONS. BIG IMPACT. QUALITY IMPROVEMENT FOR INSTITUTIONS combines the American College of Cardiology s (ACC) proven quality improvement service solutions and its
More informationPediatric Cardiology Clinical Privileges
Name: Effective from / / to / / Initial privileges (initial appointment) Renewal of privileges (reappointment) All new applicants should meet the following requirements as approved by the governing body,
More informationChanging Paradigm of Cardiovascular Care- Service Line vs Departmental
Changing Paradigm of Cardiovascular Care- Service Line vs Departmental Michael A. Acker, MD William Measey Professor of Surgery Chief of Cardiovascular Surgery Director of Penn Medicine Heart and Vascular
More informationClinical Cardiology Adult Congenital Heart Disease Clinical Service (1 month)
Clinical Cardiology Adult Congenital Heart Disease Clinical Service (1 month) During this rotation, the Cardiovascular Diseases (CD) fellow functions as an independent Cardiologist. The subspecialty trainee
More informationMarch 28, 2018 For Decision Board of Directors Item 9.0 Comprehensive Regional Cardiac Program Plan
BRIEFING NOTE March 28, 2018 For Decision Board of Directors Item 9.0 Comprehensive Regional Cardiac Program Plan PURPOSE To provide the WWLHIN Board of Directors with a recommendation to endorse the proposed
More informationAtrial Fibrillation: 2017 Update & Specialty Clinic Focus
Atrial Fibrillation: 2017 Update & Specialty Clinic Focus October 21, 2017 Gopi Dandamudi, MD FHRS System Medical Director, IUH Cardiac EP Program Director, IUH Atrial Fibrillation Center Assistant Professor
More informationREVIEW OF PROVIDENCE ALASKA MEDICAL CENTER CERTIFICATE OF NEED APPLICATION FOR CONSTRUCTION OF AN ELECTROPHYSIOLOGY LABORATORY
REVIEW OF PROVIDENCE ALASKA MEDICAL CENTER CERTIFICATE OF NEED APPLICATION FOR CONSTRUCTION OF AN ELECTROPHYSIOLOGY LABORATORY September 14, 2009 Sean Parnell Governor William H. Hogan Commissioner State
More informationUniversity of Wisconsin Madison Cardiovascular Medicine Fellowship Cardiac Electrophysiology Rotation Goals and Objectives
University of Wisconsin Madison Cardiovascular Medicine Fellowship Cardiac Electrophysiology Rotation Goals and Objectives Goal: To provide cardiovascular medicine trainees with the background knowledge
More informationEP LAB BENCHMARKING WHITEPAPER
EP LAB BENCHMARKING WHITEPAPER C. DeLaughter, MD; K. Heist, MD, PhD; B.Kind, HRSCS in sights EP LAB BENCHMARKING EXPERT PANEL INTRODUCTION C. DeLaughter, MD; K. Heist, MD, PhD; B.Kind, HRSCS In early 2014,
More informationStrategies for an Effective Structural Heart Program: Current and Future Considerations
Strategies for an Effective Structural Heart Program: Current and Future Considerations Eric L. Sarin, MD Co-Director, Structural Heart and Valve Program Co-Director, Cardiovascular Research Inova Heart
More informationACHA ACHD PROGRAM CRITERIA Comprehensive Care Center
ACHA ACHD PROGRAM CRITERIA Comprehensive Care Center A. ACHD Cardiologist B. ACHD Medical Program Director C. Advanced Practice Nurse/Physician Assistant D. Registered Nurse E. Cardiothoracic Surgery and
More informationACC State Chapters Best Practice Guide. Working with States on Clinical Data Requests
ACC State Chapters Best Practice Guide Working with States on Clinical Data Requests Prepared by: Science, Education and Quality Division As of: 3/16/2016 Contents 1. Introduction... 1 2. NCDR Registries
More informationACHP Affordability Discussion Specific Cost Savings Strategies
ACHP Affordability Discussion Specific Cost Savings Strategies December 17, 2014 ACHP News and Upcoming Events Recent Affordability Profiles: Asthma Home Visiting and Case Management program (UCare) Behavioral
More informationJOB DESCRIPTION. Electrophysiology and Devices Fellow PORTSMOUTH HOSPITALS NHS TRUST
JOB DESCRIPTION Electrophysiology and Devices Fellow PORTSMOUTH HOSPITALS NHS TRUST HG/Jan 2014 1 PORTSMOUTH HOSPITALS N.H.S. TRUST IELECTROPHYSIOLOGY AND DEVICES FELLOW INTRODUCTION Portsmouth Hospitals
More informationThe ACC Cardiovascular Board Review for Certification and Recertification
September 6 10, 2016 The Swissotel Chicago AGENDA Monday, September 5 4:00 p.m. Registration 6:00 p.m. Tuesday, September 6 7:00 a.m. Registration and Continental Breakfast 7:30 a.m. Welcome Introduction
More informationAddress: Tamar Science Park, Derriford, Plymouth. PL6 8BU. Telephone:
Issue Number 217 December 2011 Cardiac Output Cardiac Output Issue Number 217 December 2011 The Free Independent Job Vacancy and News Bulletin For Cardiology Technical Staff The Free Independent Job Vacancy
More informationSame Day Vascular Interventions in an Office or Freestanding Facility: The US Experience
Same Day Vascular Interventions in an Office or Freestanding Facility: The US Experience Jeffrey G. Carr, MD, FACC, FSCAI Founding and Immediate Past President- Outpatient Endovascular and Interventional
More informationIncrease Your Bottom Line by Eliminating Physician Driven Denials. Olakunle Olaniyan MD President Case Management Covenants
Increase Your Bottom Line by Eliminating Physician Driven Denials Olakunle Olaniyan MD President Case Management Covenants Escalating cost of care Physician Driven Denials Denial drivers Working with physicians
More informationCollaboration of the Hybrid AF Patient: Role of Advanced Practice Providers. Jennifer Walker, RN, MSN, ANP-BC UNC Center for Heart and Vascular Care
Collaboration of the Hybrid AF Patient: Role of Advanced Practice Providers Jennifer Walker, RN, MSN, ANP-BC UNC Center for Heart and Vascular Care Conclusions New paradigm has shifted towards team-based
More informationPhysician Access. Your User name is your Doctor number. * It is always 6 characters; add zeroes to the beginning if needed.
Bethesda Memorial Hospital proudly introduces Siemens' new Clinical Information System that we have named ecos (electronic Clinical Online System). You can access ecos through the Bethesda Intranet by
More informationSBAR: NCDR Registries Initiation and Feedback Phase
SBAR: NCDR Registries Initiation and Feedback Phase Title: NCDR Registries CECCV-36 Situation: Less than ~76% of TH procedure sites belong to NCDR Registries. Background: Registries ensure evidenced-based
More informationThe Evolution of ASC Joint Ventures: Key Trends for Value-Based Care
The Evolution of ASC Joint Ventures: Key Trends for Value-Based Care The Evolution of ASC Joint Ventures: Key Trends for Value-Based Care By Laura Dyrda As healthcare moves toward value-based care and
More informationPaediatric Cardiac and Adult Congenital Heart Disease: Standards Compliance Assessment
Hospital Trust: University Hospitals of Leicester NHS Trust RAG RATING: Amber/Red University Hospitals of Leicester has not demonstrated that it meets all of the requirements assessed and were considered
More informationOrange County s Health Care Coverage Initiative Network Structure: Interim Findings
Orange County s Health Care Coverage Initiative Network Structure: Interim Findings Introduction The HCCI Demonstration Program in Orange County provides health care to low-income uninsured adults and
More informationHCA PHYSICIAN SERVICES GROUP. Turning good into great for the benefit of patients nationwide CARDIOLOGY PLAYBOOK
HCA PHYSICIAN SERVICES GROUP CARDIOLOGY PLAYBOOK Turning good into great for the benefit of patients nationwide Ken Washington President of Practice Operations Executive Summary The PSG Cardiology Playbook
More informationAirStrip ONE Cardiology
AirStrip ONE Cardiology A Synchronized View of the Vital Patient Data Needed to Improve Care Heart disease is the leading cause of death in the U.S. The associated costs exceed $100 billion annually. AirStrip
More informationThe ACC Cardiovascular Board Review for Certification and Recertification
September 5 9, 2017 The Swissotel Chicago AGENDA Monday, September 4 4:00 p.m. Registration 6:00 p.m. 6:00 p.m. - Welcome Reception for Fellows in Training 7:00 p.m. Tuesday, September 5 7:00 a.m. Registration
More informationImplementation of Same Day Discharge After an Ablation Procedure for Supraventricular Arrhythmia Reduces Hospital Stay
Implementation of Same Day Discharge After an Ablation Procedure for Supraventricular Arrhythmia Reduces Hospital Stay Andreana Siu, PhD, RN, FNP; Charlotte Sunderland, MS, NP; Thomas Cheney, MS, NP; Deborah
More informationThe Liverpool Live Cardiac Resynchronisation Therapy (CRT) Course
The Liverpool Live Cardiac Resynchronisation Therapy (CRT) Course Hilton Hotel, Liverpool 19th 20th September 2011 Course Organiser: Dr Archana Rao, Consultant Cardiologist, The Live CRT course is targeted
More informationStructural Heart Program Staffing Considerations- Effective Models for Clinic, Procedure and Post Procedure Care
Structural Heart Program Staffing Considerations- Effective Models for Clinic, Procedure and Post Procedure Care Deborah Campbell Inova Fairfax Medical Campus Edwards Healthcare Leadership Series September
More informationIntermediate Coronary Care Unit Rotation
1 Intermediate Coronary Care Unit Rotation Section of Cardiology Dartmouth-Hitchcock Medical Center (2008-2009) I. Overview of Rotation The cardiology-specific critical care experience is in the Intermediate
More informationBest Practices for emeasure Implementation. Breakout Session #2: Implementation in Office-Based Practice Settings
Best Practices for emeasure Implementation Breakout Session #2: Implementation in Office-Based Practice Settings Track Leaders: Kendra Hanley John Maese, MD Michael Mirro, MD April 26, 2012 emeasure Learning
More informationCareCore National & Alliance Provider Training Material
EVIDENCE-BASED HEALTHCARE SOLUTIONS CareCore National & Alliance Provider Training Material Prepared for: March 6, 2014 Contents CareCore National... 3 Alliance and CareCore National Partnership... 4 Radiology
More informationStandards for insertion, follow up and explant of implantable loop recorders [ILRs] by non-medical staff
Standards for insertion, follow up and explant of implantable loop recorders [ILRs] by non-medical staff August 2018 First edition 1. Introduction This document has been produced by a group of arrhythmia
More informationCh. 138 CARDIAC CATHETERIZATION SERVICES CHAPTER 138. CARDIAC CATHETERIZATION SERVICES GENERAL PROVISIONS
Ch. 138 CARDIAC CATHETERIZATION SERVICES 28 138.1 CHAPTER 138. CARDIAC CATHETERIZATION SERVICES Sec. 138.1 Principle. 138.2. Definitions. GENERAL PROVISIONS PROGRAM, SERVICE, PERSONNEL AND AGREEMENT REQUIREMENTS
More informationIntro to Global Budgeting
Intro to Global Budgeting Jim Hester House Health Care Committee & Senate Health & Welfare Committee 1/21/10 Agenda Goal of global budgeting Global budget models and examples Global payment model and examples
More informationArrhythmia Care Coordinators An Update
Arrhythmia Care Coordinators An Update Jayne Mudd Senior Arrhythmia Care Coordinator James Cook University Hospital Middlesbrough The Arrhythmia Care Coordinator Role first proposed within working groups
More informationThe Veterans Health Administration CART Program: Integration of Real-Time Data Collection into the Process of Clinical Care
The Veterans Health Administration CART Program: Integration of Real-Time Data Collection into the Process of Clinical Care Paul D. Varosy, MD Director of Cardiac Electrophysiology VA Eastern Colorado
More information10/26/2017. Incorporating NPs into an EP Practice. Karla Rusk, MS, CCRN, ANP-BC, ACNP-BC Lead Nurse Practitioner, Electrophysiology. Disclosures.
Incorporating NPs into an EP Practice Karla Rusk, MS, CCRN, ANP-BC, ACNP-BC Lead Nurse Practitioner, Electrophysiology Disclosures None 2 1 Health care has become complicated. More patients.. sicker patients
More informationThe ACC Cardiovascular Overview and Board Review for Certification and Recertification
September 4 8, 2018 The Swissotel Chicago AGENDA Monday, September 3 4:00 p.m. Registration 6:00 p.m. 4:00 p.m. - Personalized Skills Center 6:00 p.m. Simulated ABIM Exam Session 6:00 p.m. - Personalized
More informationPRIMARY CHILDREN S HOSPITAL HEART CENTER
PRIMARY CHILDREN S HOSPITAL HEART CENTER 2016 OUTCOMES & CARE REPORT INTRODUCTION When you choose the Heart Center at Primary Children s Hospital in Salt Lake City, you are choosing one of the best pediatric
More informationSuccess of an MTM Program Beyond Medicare Part D: Is It Really a Pharmacy Pay for Performance Model? Jim Gartner RPh, MBA CareSource
Success of an MTM Program Beyond Medicare Part D: Is It Really a Pharmacy Pay for Performance Model? Jim Gartner RPh, MBA CareSource 10 28 2014 Learning Objectives Understand why a health plan would want
More informationYOUR TRANSPLANT TEAM. Transplant Team Who s Who. Transplant Coordinator. Pediatric Transplant Cardiologist. Pediatric Cardiac Transplant Surgeon
YOUR TRANSPLANT TEAM Transplant Team Who s Who Meet the Healthcare Team that will be working with you and your family. We at the Michigan Congenital Heart Center have many healthcare professionals working
More informationCURRICULUM AND OBJECTIVES: Gregory K. Feld, MD: CCEP Fellowship Training Program Director REVISION EFFECTIVE: July 1, 2014
1 P age UCSDHS/VASDHS CCEP TRAINING 2014 2015: CURRICULUM AND OBJECTIVES: University of California, San Diego UCSD Health System (SCVC/Thornton Hospital) and VA San Diego Healthcare System CARDIAC ELECTROPHYSIOLOGY
More informationORTHOPEDIC JOINT REPLACEMENT SURGERY: PRESCOTT VALLEY, AZ
ORTHOPEDIC JOINT REPLACEMENT SURGERY: PRESCOTT VALLEY, AZ Fellowship-trained orthopedic joint replacement doctor is hiring a second Physician Assistant. The position is primarily clinic-based with the
More informationAcceleration for ACS. NSTEMI Event 09 November. Outputs from Table Discussions
Acceleration for ACS NSTEMI Event 09 November Outputs from Table Discussions 1 1. What mechanism do we need to have to identify patients early (within 6 hours of admission to hospital)? Have identification
More informationInstructions for Completing a Human Research Billing Analysis Form
Instructions for Completing a Human Research Billing Analysis Form Principal Investigators are required to submit one Human Research Billing Analysis Form per research protocol at the time of the IRB submission
More informationBenefit Criteria for Outpatient Observation Services to Change for Texas Medicaid
Benefit Criteria for Outpatient Observation Services to Change for Texas Medicaid Information posted on October 8, 2010 Effective for dates of service on or after December 1, 2010, the benefit criteria
More informationEHRA Fellowship Program. A continuously evolving concept. Jose L. Merino
EHRA Fellowship Program A continuously evolving concept Jose L. Merino Aim The goal of this award is to help young candidates attain clinical competence and acquire high quality experience in electrophysiology
More informationAligning Hospital and Physician P4P The Q-HIP SM /QP-3 SM Model. Rome H. Walker MD February 28, 2008
Aligning Hospital and Physician P4P The Q-HIP SM /QP-3 SM Model Rome H. Walker MD February 28, 2008 A Concerted Effort Because the rewards are based on shared performance, the program is intended to create
More informationRULES for the. EUROPEAN HEART RHYTHM ASSOCIATION (EHRA) (a Registered Branch of the ESC)
RULES for the EUROPEAN HEART RHYTHM ASSOCIATION (EHRA) (a Registered Branch of the ESC) INTERNATIONAL TRAINING FELLOWSHIP PROGRAMME For clinical electrophysiology with emphasis on catheter ablation Chair:
More informationThe Regional Cardiac Care Program at Southlake
The Regional Cardiac Care Program at Southlake The Future Vision of Regional Cardiac Services Serving the Populations of York, Simcoe, Muskoka, and Dufferin Regions Copyright 2009. Southlake Regional Health
More informationRoles, Responsibilities and Patient Care Activities of Clinical Fellows. Training Program in Clinical Cardiac Electrophysiology UWMC, HMC, VAMC, NWH
Roles, Responsibilities and Patient Care Activities of Clinical Fellows Training Program in Clinical Cardiac Electrophysiology UWMC, HMC, VAMC, NWH Definitions Resident: A physician who is engaged in a
More informationVeterans Health Administration: Surveillance of Cardiovascular Disease, Diabetes Mellitus, and Chronic Obstructive Pulmonary Disease
Veterans Health Administration: Surveillance of Cardiovascular Disease, Diabetes Mellitus, and Chronic Obstructive Pulmonary Disease Paul D. Varosy, MD Director of Cardiac Electrophysiology VA Eastern
More informationFY 2014 Inpatient Prospective Payment System Proposed Rule
FY 2014 Inpatient Prospective Payment System Proposed Rule Summary of Provisions Potentially Impacting EPs On April 26, 2013, the Centers for Medicare and Medicaid Services (CMS) released its Fiscal Year
More informationBuchanan, 1996; Knaus, Felton, Burton, Fobes, & Davis 1997, J. of Nsg Administration
Can Patients with Moderate to High Risk Acute Coronary Syndromes Be Cared For safely in a Cardiac Acute Care Unit (ACU) Introduction Several studies have evaluated the safety of managing g patient with
More informationCAH PREPARATION ON-SITE VISIT
CAH PREPARATION ON-SITE VISIT Illinois Department of Public Health, Center for Rural Health This day is yours and can be flexible to the timetable of hospital staff. An additional visit can also be arranged
More informationClinical Fellowship: Cardiac Anesthesia
Anesthesia and Perioperative Medicine Western University Cardiac Anesthesia Program Director Dr. Anita Cave Please visit the Cardiac Anesthesia Fellowship site for most up-to-date information: http://www.schulich.uwo.ca/anesthesia/education/fellowship/fellowships_offered/cardiac_anesthesia.html
More informationWho is our TAVR population?
The Structural Heart Disease Patient Experience Jennifer Dollery RN, BSN Structural Heart Disease Program Manager The Ohio State University Wexner Medical Center 1 Who is our TAVR population? 2 Early TAVR
More informationCORONARY HEART DISEASE (CHD) MANAGED CLINICAL NETWORK (MCN) PROJECT BOARD
CORONARY HEART DISEASE (CHD) MANAGED CLINICAL NETWORK (MCN) PROJECT BOARD Minutes of meeting held at 5.30pm on Thursday 28 May 2009 in Meeting Room 2, Summerfield House Present: In attendance: Videolink
More informationDirect Messaging is live! Enroll for your mailbox today! Are you attesting for Meaningful Use 2 for Transitions of Care?
Direct Messaging is live! Enroll for your mailbox today! Please click HERE for more information and to enroll Are you attesting for Meaningful Use 2 for Transitions of Care? Now you can electronically
More informationCurriculum Cardiac Catheterization
Curriculum Cardiac Catheterization Description of Rotation or Educational Experience The goals of this rotation are for the cardiology fellow to develop effective technical skills in the performance of
More informationW. Douglas Weaver, MD, MACC. American College of Cardiology SENATE FINANCE COMMITTEE
Statement of W. Douglas Weaver, MD, MACC On behalf of the American College of Cardiology Presented to the SENATE FINANCE COMMITTEE Roundtable on Medicare Physician Payments: Perspectives from Physicians
More informationKern County s Health Care Coverage Initiative Network Structure: Interim Findings
Kern County s Health Care Coverage Initiative Network Structure: Interim Findings Introduction The Health Care Coverage Initiative (HCCI) program in Kern County is known as the Kern Medical Center Health
More informationAPP PRIVILEGES IN UROLOGY
APP PRIVILEGES IN UROLOGY Education/Training Licensure Required Qualifications Successful completion of a PA or NP program Current Licensure as a PA or RN in the state of CA Current certification as a
More informationSpecialised Services Service Specification. Adult Congenital Heart Disease
Specialised Services Service Specification Adult Congenital Heart Disease Document Author: Executive Lead: Approved by: Issue Date: Review Date: Document No: Specialised Planner Director of Planning Insert
More informationBundled Payments to Align Providers and Increase Value to Patients
Bundled Payments to Align Providers and Increase Value to Patients Stephanie Calcasola, MSN, RN-BC Director of Quality and Medical Management Baystate Health Baystate Medical Center Baystate Health Is
More informationConsiderations for an Outpatient Total Joint Arthroplasty Program
Considerations for an Outpatient Total Joint Arthroplasty Program Presenters Frank Gilbert Executive Director Rustin Becker President & COO Jen Edmonds Research Analyst 1 Proliance Orthopaedics and Sports
More informationJohn R. Mehall, MD, FACS, FACC Director of Cardiothoracic Surgery, Centura Health Managing Partner, Cardiac & Thoracic Surgery Associates, PC
John R. Mehall, MD, FACS, FACC Director of Cardiothoracic Surgery, Centura Health Managing Partner, Cardiac & Thoracic Surgery Associates, PC MIS MVR Over 200 cases last 3 years 0% mortality 97% repair
More informationWhat s Wrong with Healthcare?
What s Wrong with Healthcare? Dan Murrey, MD, MPP Chief Executive Officer Agenda What s wrong with healthcare in the US? What would make it better? How can you help? What s wrong with US healthcare? What
More informationUtilization of Cath Labs and Cardiovascular ORs at Hospitals with Large Heart Programs Original Inquiry Brief April 28, 2008
CARDIOVASCULAR ROUNDTABLE Utilization of Cath Labs and Cardiovascular ORs at Hospitals with Large Heart Programs Original Inquiry Brief April 28, 2008 Advisory.com RESEARCH IN BRIEF Administrators at large
More informationA BETTER WAY. to invest in employee health
A BETTER WAY to invest in employee health A BETTER WAY to take care of business Rely on A BETTER WAY Manage costs Invest in employee health Build the future 2 May 9, 2013 Kaiser Permanente 2012. All Rights
More informationWhose Cath Lab is it Anyway?
Health Care Visions News From The Cardiovascular Specialists 4 TH QUARTER 2006 Health Care Visions, Ltd. Celebrates Ten Years in Business Thank you all for being friends and clients. We look forward to
More informationQuality and Health Care Reform: How Do We Proceed?
Quality and Health Care Reform: How Do We Proceed? Susan D. Moffatt-Bruce, MD, PhD Chief Quality and Patient Safety Officer Associate Dean of Clinical Affairs Quality and Patient Safety Associate Professor
More information2018 No. 7: Radiology and Pathology/Laboratory Services
2018 No. 7: Radiology and Pathology/Laboratory Services POLICIES AND PROCEDURES Page 2 Table of Contents I. Diagnostic Radiology Policy... 3 II. Therapeutic Radiology Policy... 4 III. Pathology... 5 Page
More informationThe in-office ancillary services (IOAS)
In-Office Ancillary Services Exception Potential changes and payment implications By JoAnna Younts ELECTRONICALLY REPRINTED FROM MARCH 2015 VOLUME 30, NO. 7 EDITORS: CHRISTOPHER KENNY AND MARK POLSTON
More informationWe are growing to better serve you
We are growing to better serve you Message from Robert L. Lord, Jr. Martin Health System President and CEO Founded in 1939, Martin Health System has a rich history of providing care to residents of the
More informationMedical Plan Options - Retirees Age 65 or Over/ Disabled Participants with Medicare Coverage
Program Name U of M Retiree Plan with Group MedicareBlue SM Rx Group Platinum Blue SM Plan C with Group MedicareBlue SM Rx Freedom Plan & Freedom Plan & Type of Policy Coordinates with Medicare and includes
More informationTERESA L. EDWARDS, MHA, FACHE
TERESA L. EDWARDS, MHA, FACHE PROFESSIONAL EXPERIENCE PRESIDENT Sentara Leigh Hospital - Norfolk, VA (September 2008-Present) - 250-inpatient beds, 16 surgical suites, with 3 rd largest orthopedic program
More informationPart 4. Change Concepts for Improving Adult Cardiac Surgery. In this section, you will learn a group. of change concepts that can be applied in
Change Concepts for Improving Adult Cardiac Surgery Part 4 In this section, you will learn a group of change concepts that can be applied in different ways throughout the system of adult cardiac surgery.
More informationWholehearted HEALTH CARE
Wholehearted HEALTH CARE Chest Pain Center and Cardiovascular Intensive Care Unit: The future of cardiac care at Bon Secours St. Francis Health System 1 2 Quality Meets Compassion The Bon Secours St. Francis
More informationFor Large Groups Health Benefit Single Plan (HSA-Compatible)
Financial Features (DED 1 ) (PBP 2 ) (DED is the amount the member is responsible for before Florida Blue pays) Out-of-Network Inpatient Hospital Facility Services Per Admission (PAD) Coinsurance (Coinsurance
More informationRedesigning the Acute Coronary Syndrome (NSTE- ACS) pathway at Morriston Cardiac Centre - The case for change
Redesigning the Acute Coronary Syndrome (NSTE- ACS) pathway at Morriston Cardiac Centre - The case for change 4 th July 2012 Dr D Smith & Dr S Dorman Introduction... 2 NSTE-ACS Where are we now?... 2 NSTE-ACS
More informationGUIDE TO BAYFRONT.
GUIDE TO BAYFRONT www.bayfront.org MISSION Quality healthcare for all we serve VALUES Trust, respect and dignity reflecting our responsibility to achieve healthcare excellence for our community VISION
More informationPROVIDENCE HEALTH CARE HOSPITAL APPROVAL CONTACTS
PROVIDENCE HEALTH CARE HOSPITAL APPROVAL CONTACTS Please contact the following individuals to obtain hospital approvals (departments listed in alphabetical order below). Each hospital department or service
More informationObservation Coding and Billing Compliance Montana Hospital Association
Observation Coding and Billing Compliance Montana Hospital Association Sue Roehl, RHIT, CCS sroehl@eidebaill.com 701-476-8770 IP versus Observation considerations Severity of patient s signs and symptoms
More informationOptima Health Provider Manual
Optima Health Provider Manual Supplemental Information For Ohio Facilities and Ancillaries This supplement of the Optima Health Ohio Provider Manual provides information of specific interest to Participating
More informationAPP PRIVILEGES IN SURGERY
APP PRIVILEGES IN SURGERY Education/Training Licensure (Initial and Reappointment) Required Qualifications Successful completion of a PA or NP program Current licensure as a PA or RN in the state of California
More informationWilliam J. Ennis D.O.,MBA University of Illinois at Chicago Professor Clinical Surgery, Chief Section wound healing and tissue repair
William J. Ennis D.O.,MBA University of Illinois at Chicago Professor Clinical Surgery, Chief Section wound healing and tissue repair What are the revenue streams What are the expenses How does the hospital
More informationMadison Health s EMR Journey
A Community Connect Model: Madison Health s EMR Journey with The Ohio State University Wexner Medical Center Michael S. Browning, Madison Health Jennifer Piccione, Madison Health Stacie Gecse, RHIA, The
More informationCareFirst ICD-10 Claim Submission Guidelines
CareFirst ICD-10 Claim Submission Guidelines Introduction The U.S. Department of Health and Human (HHS) has released a HIPAA administration simplification mandate requiring all HIPAA entities to adopt
More informationST. TAMMANY PARISH SCHOOL BOARD SCHEDULE OF BENEFITS
PLAN NAME ST. TAMMANY PARISH SCHOOL BOARD SCHEDULE OF BENEFITS St. Tammany Parish School Board Active Employee Plan PLAN'S ORIGINAL BENEFIT PLAN DATE PLAN'S AMENDED BENEFIT PLAN DATE GROUP NUMBER 78B03ERC
More informationYes, for all plans, see or call for a list of network providers.
Important Questions (Massachusetts ) (New England ) (National ) What is the overall $0.00 Are there other s for specific? Is there an out of pocket limit on my expenses? What is not included in the out
More informationMagellan Healthcare 1 Frequently Asked Questions (FAQ s) For Magellan Complete Care of Florida Providers
Magellan Healthcare 1 Frequently Asked Questions (FAQ s) For Magellan Complete Care of Florida Providers Question GENERAL Why did Magellan Complete Care implement a Medical Specialty Solutions Program?
More informationCRITICAL ACCESS HOSPITALS
Are anesthesia services and post-anesthesia services medical director(s) qualified in terms of education, experience and competency as determined by the hospital medical staff and appointed by the governing
More informationPlanning for Improved Access and Orientation Anjali Joseph Jain EDRA 35
Hospital planning strategies for improving patient access and orientation within the hospital Anjali Joseph, College of Architecture, Georgia Institute of Technology Most hospitals have been designed through
More informationImproving Hospital Performance Through Clinical Integration
white paper Improving Hospital Performance Through Clinical Integration Rohit Uppal, MD President of Acute Hospital Medicine, TeamHealth In the typical hospital, most clinical service lines operate as
More informationThe Heart of Care Redesign; Care Protocols. Paul N. Casale, MD, FACC Chief, Division of Cardiology Lancaster General Health
The Heart of Care Redesign; Care Protocols Paul N. Casale, MD, FACC Chief, Division of Cardiology Lancaster General Health Lancaster General Health By the Numbers (Fiscal Year 2012) Beds: 631 in service
More informationAcute. Proposing Surgical Procedure Orders and Orders. Surgical Procedure Orders and Orders Affiliated. Requesting a Surgical Encounter FIN#:
Acute Surgical Procedure Orders and Orders Affiliated Proposing Surgical Procedure Orders and Orders Requesting a Surgical Encounter FIN#: 1. Office calls Pre-registration at 801-387-7646 or 800-624-3972.
More information