By 2035, 45 percent of the U.S. population will have at least one form of cardiovascular disease (CVD), driving the projected total cost of care to more than $1 trillion, according to research cited by presenters during a featured session sponsored by ECG Management Consultants.
Emerging cardiovascular technology, trends in ambulatory care, provider and payer partnerships, and value-based arrangements create strategic opportunities to address service demand and cost pressures.
During the session, which was a part of Becker's Cardiology Virtual Event in September, a panel of cardiovascular experts from ECG Management Consultants discussed the roles of technology, physician alignment and partnerships and value-based care in the future of CV care.
The panel included:
- Terri McDonald, RN, associate principal
- Sean Hartzell, associate principal
- Purvi Bhatt, senior manager
Five key takeaways:
1. Clinical advancements continue to redefine CV care. Current diagnostic and therapeutic technology advancements, including improved drug therapies, advanced imaging and catheter-based procedures, remote patient monitoring, and augmented intelligence and robotics will continue to evolve and help patients live longer, manage their disease more effectively and seek less-invasive interventions. "With these tools, we'll actually be able to leverage these clinical advancements to support more personalized care," Ms. McDonald said.
2. Care is shifting away from traditional hospital settings to lower-cost sites, including ASCs. Transition to outpatient settings is accelerating, especially as the lower cost of care associated with ASCs is driving payer contracting and partnerships.. To remain competitive, the CV industry will need to think differently about care as a continuum, looking at new strategies to cut waste, create efficiencies, adopt effective treatment protocols and invest in ambulatory sites of care.
Federal and state regulations, including certificate of need, reduced rates of reimbursement and significant cost outlays for capital investment, overhead and supplies remain barriers to this shift. These hurdles can be overcome, however. "There are a lot of potential industry partners out there eager to help with these challenges," Ms. McDonald said.
3. The migration of CV volume to the outpatient setting is driving enhanced alignment between physicians and hospitals. As more organizations develop outpatient settings for cardiovascular services, they need to evaluate how best to partner and align with physicians. Hospitals need to understand the impact of physician employment, their access to capital necessary to develop these locations and how much equity should be available to physician investors to effectively impact success of the ASC. Understanding the structure of care is also critical. "If we're moving patients to an ambulatory site of care, do these patients have ready access to an acute site of care should there be a complication during the procedure?" Mr. Hartzell asked.
4. Cardiovascular disease services are moving toward value-based care delivery models. The increasing prevalence of CVD combined with innovations in care are increasing total healthcare costs, making value-based care delivery models a necessity.
Payers are interested in shifting sites of care, alignment with physicians, and emerging technology as these all have the potential to lower costs while improving clinical outcomes. Organizations and payers need to monitor key performance indicators such as quality and cost, though, to ensure that these newer offerings positively impact overall care. "All of these industry trends are impacting key stakeholders, such as payers, employers, provider groups and patients in their own ways," Ms. Bhatt said. "They, in turn, are furthering the evolution of value-based care delivery."
5. Alternative payment models range from shared savings to full-risk models. Most APMs related to CV care are structured as bundled payments or longitudinal models. Bundled payments consist of set payments around CV episodes of care. The primary-care-focused longitudinal model ties payments to effective management of a target population, while the specialty care model ties care to specific conditions; while CV is just now emerging as a specialty for longitudinal models, effective CV care has long been a driver of success for primary care models.
To learn more about the event, click here.