cardiologists

DoJ joins whistle-blower suit against OH MDs, hospital

Wed, 02 Apr 2008 07:59:57 -0400

The U.S. Department of Justice has added its firepower to a whistle-blower lawsuit contending that a hospital in Cincinnati was rewarding cardiologists who generated the most revenue for the hospital. The suit, which originally was filed in 2003 by cardiologist Harry Fry, contends that Cincinnati's Christ Hospital conspired together with a large cardiology group, Ohio Heart & Vascular Center, to make sure that cardiologists had access based only on how much revenue they brought in the previous year. The suit also contends that cardiologists in the group were rewarded for their collusion in this scheme with a kickback, in this case an opportunity to bill patients for diagnostic services, the DoJ says. Lawyers for the 511-bed hospital, of course, say the suit is without merit.

To learn more about the case:
- read this Modern Healthcare article (reg. req.)
- read the DoJ press release

Related Articles:
HHs OKs hospital/physician gain sharing. Report
HHS gives health centers an anti-kickback break. Report
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HHS Ok's hospital/physician gainsharing

Wed, 16 Jan 2008 06:59:56 -0500

Two gainsharing arrangements between a hospital and physician groups have gotten an OK in advisory opinions from the HHS Inspector General's office. The ruling assures the applicant(s) that they'd be unlikely to face a civil monetary penalty or accusations of violating the anti-kickback statue for making these arrangements. While it's not clear how widespread the influence of these decisions will be--they appear to be advice to one hospital, though the name has been redacted from the documents--they still shed at least some light on an issue which continues to trouble hospitals.

In its advisory opinion, the HHS IG ruled that plans for sharing cost savings with cardiologists and anesthesiologists at the unnamed hospital aren't likely to harm patients or encourage kickbacks, because the hospital had provided well-detailed rules which were tied to measurable clinical measures. For example, the system allows anesthesiologists to use a cheaper type of catheter in 90 percent of cases, but won't allow them to gain when the number of uses goes above 90 percent.

To learn more about the advisory opinion:
- read this Modern Healthcare item
- read the IG opinions

Related Articles:
CMS seeks rural hospitals for gainsharing program. Report
HHS gives health centers an anti-kickback break. Report

Study: Nurse-driven heart failure support boosts compliance

Tue, 06 Nov 2007 06:59:54 -0500

A new study suggests that if heart failure patients get intensive support from a heart failure nurse and a multidisciplinary team, they're more likely to comply with key non-medical interventions like salt and fluid intake restrictions and regular weigh-ins. The study looked at 1,023 heart failure patients, average age 71, treated at 17 hospitals, and divided them into groups getting standard cardiologist visits only, cardiologist visits plus education and counseling from a heart failure nurse, and intensive counseling from a heart failure nurse, dietician, social worker and physiotherapist.

During the study, researchers found that patients receiving support improved their compliance over their status prior to the study in several key areas. For example, 90 percent of support group patients met fluid restrictions, compared with 67 percent prior to the study, while there was no change in the control group. Meanwhile, patients in the support group were also more aware of symptoms of worsening heart failure, researchers found.

To learn more about the study:
- read this HealthDay News piece

Related Articles:
Nurse-trained patients less likely to be readmitted. Report
Health coaches guide post-ED care. Report

Study: Drug coated stents may be safe

Fri, 14 Sep 2007 06:59:57 -0400

In recent times, controversy has raged over whether drug-coated stents are safe to use for cardiac patients. The debate arises from recent studies suggesting that some stents can actually raise the risk of heart attacks.

However, new research has been published which suggests that the stents are safer than previously thought. The study, published in The Lancet, suggests that patients receiving drug-coated stents to open coronary arteries aren't any more likely to die than patients with bare-metal stents. To draw these conclusions, researchers did an analysis on 38 previously-reported clinical trials.

To find out more about the study:
- read this article from the New York Times News Service

Related Articles:
Cardiologists stand by stents. Report
Medical device makers to fund stent safety study. Report
Decline in drug-coated stent use at major cardiac centers. Article

Cardiologist investigated for allegedly striking patient

Wed, 12 Sep 2007 06:59:55 -0400

A high-profile San Diego cardiologist is under CMS investigation for allegedly hitting a patient several times during a cardiac catheterization. The physician, Dr. Maurice Buchbinder, is a controversial figure who's been up against federal authorities before, last time for using an unapproved device developed by a company in which he had a financial interest. Buchbinder practices within the Scripps hospital system, which performs more heart procedures than any other in the U.S.

Dr. Buchbinder was targeted after lab technicians filed complaints with state licensing officials alleging that he had struck an unruly patient several times during a cath procedure done on August 31st. The complaints triggered the CMS investigation. Scripps has since announced that Buchbinder has been suspended indefinitely from practicing at any Scripps facility nationwide.

To learn more about the investigation:
- read this San Diego Union-Tribune article

SPOTLIGHT: Stent problems change cardiology tactics

Mon, 10 Sep 2007 06:59:52 -0400

In recent times, research has raised serious questions about safety of drug-coated stents, which are used to protect patients against complications from some forms heart disease. Since then, cardiologists have begun to change their strategies, using the once-standard angioplasty-plus-stents approach far less often. Instead, they're opting for surgical solutions more often. Article

Study: Too few patients get clot-busting drugs

Mon, 06 Aug 2007 06:59:55 -0400

While the number of heart attack patients getting angioplasties or clot-busting drugs has climbed over the past 10 years, 10 percent of patients don't seem to be getting the drugs at all, according to a new study published in the American Journal of Medicine.

The patients who most likely to miss out on such treatment are those who have an atypical presentation, or in other words, didn't have typical heart-attack symptoms such as chest pain. Patients who arrived six or more hours after the start of the attack, people over the age of 75, women and non-white patients were also less likely to receive such lifesaving treatments. (The idea that gender and ethnic lines matter is particularly troubling, in my view.)

Cardiologists from the University of Michigan Cardiovascular Center and the Yale University School Medicine conducted the study. To draw their conclusions, the researchers looked at 238,291 patients who had an ST-elevated myocardial infarction which could have been treated in this manner. The research was funded by the National Heart, Lung and Blood Institute of NIH.

To find out more about the study:
- read this press release from the University of Michigan Health System

Related Articles:
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Improving stroke outcomes. Report
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Closing the racial care gap--ideas in play. Column
UnitedHealth launches minority health initiative. Report

Pediatric stent-maker faces FDA investigation

Thu, 05 Jul 2007 20:01:38 -0400

A company that makes coronary stents and catheters for pediatric use is facing an investigation by the FDA and federal prosecutors, who contend that it promoted non-approved stents for use in children. They say device maker NuMed sold more than 30 stents to the DuPont Hospital for Children in Wilmington, Del., but didn't file for FDA approval prior to selling the stents as agency regs require. If the FDA investigation moves forward, NuMed ultimately could be banned from selling the devices in the United States, forcing children to go to Europe if they need this device. NuMed also would be forced to pay several million dollars in fines.

Alarmed by the FDA investigation, about 600 cardiologists and parents worldwide have begun circulating a petition asking the agency to drop the NuMed investigation. They say the NuMed products are safer than using adult stents on children, and that stopping their sale could harm young heart patients substantially.

To learn more about the investigation:
- read this United Press International piece
- and this Wall Street Journal report

Related Articles:
Insurers may cut stent payouts. Report
Decline in drug-coated stent use at top cardiac centers. Report
Stent study surprises clinicians. Report
Cardiologists stand by stents. Report

Study:Primary care costs, reimbursement low

Wed, 25 Apr 2007 20:01:37 -0400

Primary care costs much less than specialty care, but insurers aren't necessarily taking that into account, according to a new study. The study, by HHS's Agency for Healthcare Research and Quality, noted that while orthopedist fees averaged $210 per visit, and cardiologists $232 per visit, primary care physicians typically charge $100 per visit. But insurers still penalize primary care, requiring patients to pay an average of 20 percent of PCP costs out-of-pocket. Despite higher costs, specialty co-pays were lower, the AHRQ found. For example, insurers only required consumers to pay 16 percent of orthopedist fees and 13 percent of cardiologist fees. These results are a bit of a surprise, given that health plans have every reason to encourage prevention-oriented primary care treatment. Sounds like it's time for some benefits tweaking.

To find out more about the study:
- read this United Press International article

Related Articles:
Study: Lower pay threatens PCP supply. Report
Study examines primary care doc satisfaction. Report
Program offers improved training for PCPs. Report
GAO: 10% of PCPs provide extra services. Report

ALSO NOTED: Revolution Health launches; TX leads in uninsured rolls; and much more...

Mon, 16 Apr 2007 20:01:30 -0400

> Closely-watched consumer health site RevolutionHealth.com should launch this week. The project is funded by AOL founder Steve Case. Article

> Texas has the nation's highest rate of uninsured citizens, researchers say. Article

> Experts are arguing that The Global Fund should pay for health worker salaries, not just medical treatments. The Fund helps countries fighting AIDS, tuberculosis and malaria, but has traditionally focused on treatment rather the staffing. Article

> A pair of Indianapolis cardiologists have won the first round in their battle to keep practicing locally. They had previously been blocked a noncompete contract with a former employer. Article

And Finally... Don't you wish you could have your own mammoth? Article