Cost Comparison between Heart Transplantation and Left Ventricular Assist Device Implantation

Kilic, Ahmet; Phillips, Gary; Chimanji, Neeraj; Sai-Sudhakar, Chittoor; Hasan, Ayesha; Higgins, Robert S.D.; Whitson, Bryan A.

doi:10.1016/j.cardfail.2014.06.238

Cited by 3 publications

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“…12 Moreover, the frequency and magnitude of outlier payments for these hospitalizations suggest that current DRG payment rates are not sufficient to cover the cost of durable LVAD implants in hospitals, which may be because the DRG codes used for durable LVAD implants are the same used for potentially less costly procedures including heart transplant. [21][22][23] Creating a separate DRG payment rate for durable LVAD therapy may result in less spending variation.…”

Section: Discussionmentioning

confidence: 99%

Center Variation in Medicare Spending for Durable Left Ventricular Assist Device Implant Hospitalizations

et al. 2019

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IMPORTANCE Hospitalizations for durable left ventricular assist device (LVAD) implants are expensive and increasingly common. Insights into center-level variation in Medicare spending for these hospitalizations are needed to inform value improvement efforts. OBJECTIVE To examine center-level variation in Medicare spending for durable LVAD implant hospitalizations and its association with clinical outcomes. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study of linked Medicare administrative claims and Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) clinical data comprising 106 centers in the United States providing durable LVAD implant. Centers were grouped into quartiles based on the mean price-standardized Medicare spending of their patients. The study included Medicare beneficiaries receiving primary durable LVAD implant between January 2008 and December 2014. Data were analyzed between November 2017 and October 2018. MAIN OUTCOMES AND MEASURES Price-standardized Medicare payments and clinical outcomes. Overall and component (facility diagnosis-related group payments, outlier payments, physician services) payments and clinical outcomes (postimplant length of stay and adverse events) were compared across payment quartiles. RESULTS The study sample included 4442 hospitalized patients, with mean (SD) age of 63.0 (10.8) years, 18.7% female, 27.2% nonwhite, and 6.1% Hispanic ethnicity. Among 4442 hospitalizations, the mean (SD) price-standardized Medicare payment was $176 825

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Section: Discussionmentioning

confidence: 99%

Center Variation in Medicare Spending for Durable Left Ventricular Assist Device Implant Hospitalizations

et al. 2019

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“…Cardiac transplant is the only established, cost-effective therapy for end-stage heart failure. 1 Median survival following cardiac transplant is now greater than 13 years, and as a result many patients are now surviving until they develop cardiac allograft vasculopathy (CAV). 2 In patients who survive at least 5 years after transplant, CAV accounts for over a third of deaths, many of which occur suddenly.…”

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confidence: 99%