Are hospitals making a bundle off of unnecessary diagnostic coronary angiographies?
Yes, according to Connecticut cardiologist Evan Levine, M.D.
Levine cited a recent study in the American Heart Association journal Circulation: Cardiovascular Interventions of the invasive catheterization procedure performed at hospitals in New York State in 2010 and 2011. The study found that nearly a quarter of such procedures it examined--more than 2,200--were inappropriate based on existing guidelines for performing the procedure. Nearly 40 percent were classified as "uncertain," which means the need for such a procedure was unclear. Only slightly more than 35 percent were considered appropriate given the patient's health, performance on a cardiac stress test and history of heart disease.
"For a procedure that can be performed in under half an hour ... the bill for a simple angiogram can reach $8,000 or more. By comparison, it would require a general practitioner to see about 124 patients, for an intermediate visit, in order to bill $8,000 (based on Medicare rates)," Levine wrote in the Ridgefield Press. "A typical catheterization lab cab perform 12 such procedures daily, grossing $96,000."
As a result, "many small community hospitals opened labs, even when hospitals with established full-service centers and excellent track records were just minutes away," Levine wrote. Moreover, physicians with less than distinguished careers who performed high volumes of angiographies were recruited over those who were less likely to order such a procedure.
Unnecessary testing is considered the banes of healthcare delivery and an ongoing contributor to its escalating costs. The AARP Bulletin recently published a list of 10 overused tests that cost the healthcare system billions of dollars a year.
"The numbers published from the New York state database are a result of a system that encourages hospitals to perform expensive studies and to seek out physicians, whether or not they are honest and qualified, to fuel a money-making machine," Levine wrote.