Private practice with Dr Seth Bilazarian

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What to do about hospital readmission rates

Oct 16, 2012 09:05 EDT


As the CMS moves to cut reimbursement based on high rates of hospital readmission for MI, heart failure, and pneumonia, how can cardiologists—working with other healthcare providers, patients, and their families—provide optimum care and keep people out of the hospital?





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Your comments
What to do about hospital readmission rates
# 1 of 2
October 26, 2012 11:16 (EDT)
SandeOlson
Excellent presentation Dr. Bilazarian.  Thank you for taking the time to provide the cardiologist perspective.
# 2 of 2
October 27, 2012 12:06 (EDT)
Albert Adams, Ph.D.

Seth:

I always enjoy your talks. This one on readmissions is particularly valuable. Given my own experiences with a MI back in 2008 at holiday season one of the flaws appears to be how and who to get back in touch with after leaving the hospital.

The cardiologist assigned to me by the Hospital was off on his vacation and patients were told to either contact their GP or go to the emergency (i.e. creating as in my case an unnecessary readmission, if I had followed his telephone recorded instructions.) Of course my GP was also unreachable during holiday.

Like our Nova Scotia gas stations during the summer, when most take off someone is assigned to remain on duty–and it does not have to fall by default to further burdening the hospitals.

Place some limiting but real economic liability, within the profession and among colleagues on all specialists who does not provide for their own vacation back up–and it should not be the hospital. Being lazy and passing the buck to hospitals the best prepared but also most expensive and holiday season overworked caring unit within our systems is the old fashion way of handling such problems. But, it is becoming less and less the best way to go!

You have hit a very vital nail on the head. Keep us focused on getting better at what we do. You are a very good gad fly! 

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About Dr Seth Bilazarian
Seth Bilazarian MD has been a Clinical and Interventional Cardiologist at Pentucket Medical Associates in Massachusetts since 1993. He is board certified in Internal Medicine, Cardiovascular Medicine, Nuclear Cardiology, Vascular Ultrasound, Interventional Cardiology, and Vascular and Endovascular Medicine.

Dr Bilazarian performs coronary and peripheral interventions at Lahey Clinic and Massachusetts General Hospital. He has been an investigator in the interventional laboratory for new devices including drug-eluting stents, distal protection devices, imaging devices (OCT and InfraRed), and anticoagulant pharmacotherapy.

Dr Bilazarian is an active participant in clinical trials in congestive heart failure, hypertension, coronary disease prevention, prediabetes management, anemia, atrial fibrillation, and anticoagulation/antiplatelet therapies in the outpatient setting. He has authored numerous papers and book chapters in clinical cardiology. He was appointed as a physician advisor to the circulatory device panel of the FDA in 2008.
About this blog
My intent is to create a forum for dialogue on issues pertinent to private practice cardiology around topics such as:

  • Integration of new data and guidelines on inpatient and outpatient practice in clinical and interventional cardiology
  • Practice approaches to the extra clinical issues in dealing with managed care insurers
  • Strategies for navigating the restrictions of pharmacy benefits managers (PBMs) on pharmacologic therapies for our patients
  • Experiences with restrictions on testing and imaging
The video blog (VLOG) will provide an opportunity to share broadly different approaches to the common conundrums we face in caring for patients. My hope is that this forum will provide useful data points for practice outside of tertiary and academic centers and a look inside community hospitals and physician?s practice patterns in the office, starting with mine.