New heart valve procedure could be big windfall for hospitals

As open-heart surgeries become a dicier option for an aging patient population, a new catheterization procedure could wind up being a major money-maker for hospitals in the years and decades ahead, according to Kaiser Health News.

The transcatheter aortic valve replacement, or TAVR, has been performed in the U.S. since 2011, according to the article. It has become an option for patients with blocked or leaky valves who are too old or frail to undergo an open heart procedure.

Valve procedures in the U.S. have increased more than 50 percent since 2012, in part due to the increasing numbers of TAVRs being performed. That number is expected to increase 25 percent year over year, to some 20,000 performed in 2015, KHN reports.

Such procedures can prove to be quite lucrative for hospitals as the frequency of other cardiac surgeries, such as open heart valve and coronary artery bypass graft surgeries, decrease. Medicare pays Morton Plant Hospital in Florida $30,000 to perform a TAVR, and the procedure has helped contribute to the facility's 17 percent operating margin, according to KHN.

However, the procedure's relative newness has also raised concerns among providers. Verdi DiSesa, M.D., chief operating officer at Temple University Health System, suggested that their use be limited to "centers of excellence" for the time being. He noted that 10 providers in the Philadelphia area already perform TAVRs.

And there has been some questions about whether some cardiac procedures are medically necessary. Asad Qamar, M.D., a Florida cardiac surgeon, was recently barred from the Medicare program for relentlessly overbilling. He billed $16 million in 2013; the average cardiologist in Florida bills about $260,000. In New York State, Westchester Medical Center recently settled charges of performing unnecessary cardiac procedures by paying $18.8 million.

To learn more:
- read the KHN article

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