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Future of the PCI Readmission Metric.
Circ Cardiovasc Qual Outcomes. 2016 Mar; 9(2):186-9.CC

Abstract

Between 2013 and 2014, the Centers for Medicare and Medicaid Services and the National Cardiovascular Data Registry publically reported risk-adjusted 30-day readmission rates after percutaneous coronary intervention (PCI) as a pilot project. A key strength of this public reporting effort included risk adjustment with clinical rather than administrative data. Furthermore, because readmission after PCI is common, expensive, and preventable, this metric has substantial potential to improve quality and value in American cardiology care. Despite this, concerns about the metric exist. For example, few PCI readmissions are caused by procedural complications, limiting the extent to which improved procedural technique can reduce readmissions. Also, similar to other readmission measures, PCI readmission is associated with socioeconomic status and race. Accordingly, the metric may unfairly penalize hospitals that care for underserved patients. Perhaps in the context of these limitations, Centers for Medicare and Medicaid Services has not yet included PCI readmission among metrics that determine Medicare financial penalties. Nevertheless, provider organizations may still wish to focus on this metric to improve value for cardiology patients. PCI readmission is associated with low-risk chest discomfort and patient anxiety. Therefore, patient education, improved triage mechanisms, and improved care coordination offer opportunities to minimize PCI readmissions. Because PCI readmission is common and costly, reducing PCI readmission offers provider organizations a compelling target to improve the quality of care, and also performance in contracts involve shared financial risk.

Authors+Show Affiliations

From the Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (J.H.W.) and The Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (R.W.Y.). jwasfy@mgh.harvard.edu.From the Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA (J.H.W.) and The Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (R.W.Y.).

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26812931

Citation

Wasfy, Jason H., and Robert W. Yeh. "Future of the PCI Readmission Metric." Circulation. Cardiovascular Quality and Outcomes, vol. 9, no. 2, 2016, pp. 186-9.
Wasfy JH, Yeh RW. Future of the PCI Readmission Metric. Circ Cardiovasc Qual Outcomes. 2016;9(2):186-9.
Wasfy, J. H., & Yeh, R. W. (2016). Future of the PCI Readmission Metric. Circulation. Cardiovascular Quality and Outcomes, 9(2), 186-9. https://doi.org/10.1161/CIRCOUTCOMES.115.002472
Wasfy JH, Yeh RW. Future of the PCI Readmission Metric. Circ Cardiovasc Qual Outcomes. 2016;9(2):186-9. PubMed PMID: 26812931.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Future of the PCI Readmission Metric. AU - Wasfy,Jason H, AU - Yeh,Robert W, Y1 - 2016/01/26/ PY - 2016/1/28/entrez PY - 2016/1/28/pubmed PY - 2016/12/16/medline KW - Medicare KW - coronary heart disease KW - percutaneous coronary intervention KW - quality assessment, healthcare KW - quality improvement KW - risk adjustment SP - 186 EP - 9 JF - Circulation. Cardiovascular quality and outcomes JO - Circ Cardiovasc Qual Outcomes VL - 9 IS - 2 N2 - Between 2013 and 2014, the Centers for Medicare and Medicaid Services and the National Cardiovascular Data Registry publically reported risk-adjusted 30-day readmission rates after percutaneous coronary intervention (PCI) as a pilot project. A key strength of this public reporting effort included risk adjustment with clinical rather than administrative data. Furthermore, because readmission after PCI is common, expensive, and preventable, this metric has substantial potential to improve quality and value in American cardiology care. Despite this, concerns about the metric exist. For example, few PCI readmissions are caused by procedural complications, limiting the extent to which improved procedural technique can reduce readmissions. Also, similar to other readmission measures, PCI readmission is associated with socioeconomic status and race. Accordingly, the metric may unfairly penalize hospitals that care for underserved patients. Perhaps in the context of these limitations, Centers for Medicare and Medicaid Services has not yet included PCI readmission among metrics that determine Medicare financial penalties. Nevertheless, provider organizations may still wish to focus on this metric to improve value for cardiology patients. PCI readmission is associated with low-risk chest discomfort and patient anxiety. Therefore, patient education, improved triage mechanisms, and improved care coordination offer opportunities to minimize PCI readmissions. Because PCI readmission is common and costly, reducing PCI readmission offers provider organizations a compelling target to improve the quality of care, and also performance in contracts involve shared financial risk. SN - 1941-7705 UR - https://www.unboundmedicine.com/medline/citation/26812931/Future_of_the_PCI_Readmission_Metric_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.115.002472?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -