ECHO 2013 / Echocardiography in 2013 and Beyond Where We Are and Where We Are Going
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Cardiac CT |
Cardiac MR |
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*Data represent global and professional service billing for services in Medicare fee-for-service at all sites of service (inpatient hospital, physician office, etc.).
*Cardiac CT was reported with Category III codes from 2007 through 2009. Chart shows utilization of Category III codes (0144T-0150T) through 2009 and new Category I codes (75571-75574) starting in 2009.
*Cardiac MR codes were revised in 2008. Chart shows utilization of old codes (75552-75556) through 2007 and new codes (75557-75563) starting in 2008.
MR2010:21
Percent Change in CV Imaging
*Data represent global and professional service billing for services in Medicare fee-for-service at all sites of service (inpatient hospital, physician office, etc.).
*Percent change calculation divides utilization of one year by the previous year. *Percent changes to Cardiac MR are highly sensitive due to low utilization. *Percent changes to Cardiac CT are highly sensitive due to low utilization.
MR2010:22
And Now We Have Health Care Reform
Becky and Richard at a Tea Party Rally
MR2010:23
The Four-Legged Stool of Health Reform
Affordable universal care
Cost containment
Universal access
Low-income support
Universal enrollment
MR2010:24
Key Provisions of the Patient Protection and Affordable Care Act of 2010
•“Children” remain on parental health insurance until age 26
•Subsidies for insurance purchase for incomes between 139% and 400% of the Federal Poverty Level
•Mandate to purchase insurance (prevent free-riders)
•Insurance exchanges to encourage competition and prevent underwriting based on health status
•Penalties for failing to purchase insurance ($2085 per family or 2.5% household income, whichever greater)
•Medicaid for all below 139% of Federal Poverty Level
MR2010:25
Key Provisions of the Patient Protection and Affordable Care Act of 2010
•Creation of standard health policy
•Limit out of pocket spending ($11,900 for families)
•Guarantee issue and renewal
•Eliminate lifetime and annual limits on benefits
•Premiums can be based only on:
–Age (3:1)
–Tobacco use (1.5:1)
–Family size
–Geography
– No consideration for health status
MR2010:26
7 Trends in Healthcare (And How Echocardiography Can Lead The Way)
•The Value Proposition
•The Triple Aim
•Focus on Patient Safety
•1 Patient, 1 Test
•Patients as Partners
•From Fee for Service to Population Health
•A Focus on Appropriateness
MR2010:27
7 Trends in Healthcare (And How Echocardiography Can Lead The Way)
•The Value Proposition
•The Triple Aim
•Focus on Patient Safety
•1 Patient, 1 Test
•Patients as Partners
•From Fee for Service to Population Health
•A Focus on Appropriateness
MR2010:28
Value = Quality/Cost
Someone Elses Determines Cost
WE Can Control Quality!
MR2010:29
Keys to Quality
Contrast for Endocardial Definition
63 yo Man with Chest Pain
Polar bear in a snowstorm |
Ah, now it‟s clear |
?apical dyskinesis |
Normal! |
MR2010:30