Hospitals' unnecessary stent use costs Medicare $800M a year

More than 229,000 unnecessary coronary stents were performed at U.S. hospitals from 2019 to 2021 — a rate of one every seven minutes, according to a newly published report from the Lown Institute. 

The independent think tank used Medicare claims data to examine the overuse of percutaneous coronary interventions, which includes coronary stent or balloon angioplasty, at 1,773 hospitals with the capacity to perform the procedure. 

"Stents were defined as meeting overuse criteria for patents with a diagnosis of ischemic heart disease at least six months prior to the procedure, excluding patients with a diagnosis of unstable angina or heart attack within the past two weeks, and excluding patients who visited the emergency department over the past two weeks," the report said. Read more about the methodology here

Some key findings: 

  • Overall, more than 229,000 procedures met the criteria for overuse from 2019-21. 
  • The report estimates more than 20% of stents were placed unnecessarily in Medicare  patients, costing about $2.44 billion.  
  • Rates of overuse varied widely across hospitals. At some hospitals, for example, more than half of stands met criteria for overuse, while others had a rate of less than 5%. 

Coronary stents have long been used to help restore adequate blood flow in patients with narrowed arteries. Over the years, research has shown they offer no benefit over optimal medication therapy among patients with stable heart disease. 

"The frequency at which stents are overused shows that many physicians are struggling to keep up with the evidence," Vikas Sani, MD, cardiologist and president of the Lown Institute, said in an Oct. 31 news release. "To be socially responsible, hospitals need to take a more active role in reducing these unnecessary procedures."

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