Taking the pulse of cardiovascular services
By Matt Patterson, M.D., July 23, 2013
Three reasons why cardio care is ripe for mobility.
Mobility is making an impact on cardiovascular services – ranging from expedited STEMI (ST elevation myocardial infarction) care pathways to readmission reductions for congestive heart failure (CHF) and intermittent dysrhythmias. Taking a step back to reflect on the state of the cardiovascular service line at large illustrates some key pressures that health systems are experiencing and why mobile technology solutions are taking off in this area.
- Cardiovascular services are a critical source of revenue, and will continue to be for the foreseeable future. Cardiovascular services represent upward of 50 percent of net patient revenue, and as much or even higher fully loaded EBITDA (earnings before interest, tax, depreciation and amortization) for many health systems. It's also one of the few service lines where even a relatively high-cost player can turn a fully loaded EBITDA positive margin. Consistent performance improvement in cardiovascular services is a near-term imperative for most, if not nearly all, U.S. health systems.
- At the same time, overall cardiovascular services growth is slowing. Many indicators show that despite an aging population, overall cardiovascular services growth is projected to decline. This is the case for all sub-service lines, with the exception of electrophysiology (EP) showing modest growth potential. Potential explanations include advancement in medical management (e.g., lipid-lowering medications), shift to interventional cardiology procedures over surgeries, and stricter clinical criteria and reimbursement policies for those interventions. Despite some excitement about transcatheter valve replacements, electrophysiology advances and renal denervation, the intervention innovation pipeline does not point to robust growth in procedural-based care at large.
- Thus, the cardiovascular service line sits at an inflection point. The factors above create a complex dilemma. Health systems recognize the absolute necessity of generating earnings in cardiovascular services, but the outlook shows a real threat due to declining growth. So it becomes a matter of a health system’s ability to grab a larger piece of a dwindling pie while maximizing margin, particularly for Medicare patients. The cardiovascular service line is like a drug that health systems are addicted to – and getting a “fix” is becoming more and more challenging.
These factors make cardiovascular services ripe for mobility. Health systems must foster care pathway innovation to survive – growing the top line through strategic differentiation and creation of an attractive environment for physicians and patients while executing leaps in efficiency and quality to bend the cost curve.
About the author
Matt Patterson, M.D., is chief transformation officer, AirStrip. To learn more about AirStrip, go to www.airstrip.com.
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