For a diabetic's stand point, there should be an adjustment for the immediate time after the surgery where with a PCI the recovery time is days compared to open heart surgery where it is months to years. Because of the large number of deaths associated with open heart surgery in the short term frailer patients may need a PCI verses open heart surgery. Part of the cost saving of open heart surgery may be that ONLY the healthier survive the operation so the cost of health care for healthier is lower in the short term. I wonder about the model used to predict future cost because such models are NOT always accurate.