Hospitals Focus on Updating Cardio Service Lines

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In the entertainment industry, it’s common practice to take long-running franchises and reboot or restart them, with the hope of giving the properties a fresh, contemporary spin.

In the March 2013 issue of HealthLeaders Media magazine, Michael Zeis reports on the rebooting of cardio service lines at healthcare organizations around the country. He writes, “Those responsible for cardio service lines are placing more emphasis on patient behavior. Closely and loosely aligned partners, often practicing in the community and not in the hospital, are playing pivotal roles in expanding the patient referral base in new ways. And even though there is more emphasis on care outside the hospital, for the most part, healthcare leaders expect stability in cardio revenues and contribution margins, partly as a by-product of industry consolidation.”

Zeis says this reboot can be seen in the shift toward prevention that many organizations have made. According to a HealthLeaders Media Intelligence Report, 50 percent have made “prevention programs …critical parts of their cardio service lines,” with 47 percent emphasizing wellness programs. You can expect these percentages to increase over the next three or so years, Zeis forecasts, with 62 percent emphasizing prevention and 54 percent wellness, “while inpatient drops from 69 percent to 35 percent.”

“[We’ve been through] a big transformation of care,” said Laura Robertson, RN, chief executive officer of Arizona’s Banner Heart Hospital. “We brought in a post-acute care skilled-nursing facility and home care. With them we designed cardiac units in their skilled-nursing facilities and [established] cardiac teams to manage patients through home care. [Now they are] more successful at assessing, understanding what to do, managing both resources and patients in the home.”

The question then becomes, “With a shift away from inpatient care for some services, what happens to cardio revenues?” Some organizations, like Piedmont Physicians Organization, are using their wellness programs to “prompt early medical encounters with the population at large, maximizing the opportunities to establish relationships with patients.”

As Zeis notes, this sounds suspiciously like marketing jargon. President and CEO Sid Kirschner prefers to call it “a mutual-benefit endeavor. You want to capture the patient as early as possible in your cycle. It’s a combination of preventive health benefit for the patient as well as a marketing program. So now that you have the patient, as the patient ages and has a problem, the patient is in your system.”

Many organizations are also increasing their imaging services to produce more revenue from cardio. The Intelligence Report found that “the cardio service line remains a leading service line in terms of financial contribution,” with “74 percent of healthcare leaders [expecting] to expand their cardio service lines in the next three years.”

Physician alignment has also become more important to the success of a cardio service line. “More than ever, we are aligning with medical staff. For the cardio service line, you need cardiologists who are committed to your facility to bring business, ensure quality and service, and manage costs,” Robertson said. Interventional cardiologists are especially in demand, she adds, since “interventional cardio is the real driver of reimbursement. They’ll do the procedures like catheters and stents. A noninterventional cardiologist can do a diagnostic catheterization, but they can’t do any interventions.”

How are you developing or even rebooting your cardio service line? What have you added or removed from your service line? How has it affected the quality and efficiency of your care?

-by Pete Fernbaugh

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