Healthcare Financial News

Medicare patients who receive ventricular assist devices (a type of heart pump) have high rates of death, illness, and prolonged hospital stays, with resulting high costs of care, according to a study in the November 26 issue of JAMA.
 
A ventricular assist device consists of a mechanical pump that takes over the function of a damaged ventricle of the heart and helps restore normal blood flow. In 2003, Medicare expanded coverage of ventricular assist devices as permanent therapy for end-stage heart failure. Little is known about the long-term outcomes and costs associated with these devices.
 
Researchers analyzed trends in use, outcomes and costs of ventricular assist devices for all Medicare fee-for-service beneficiaries from February 2000 through June 2006. This study included beneficiaries who received a ventricular assist device as primary therapy (primary device group) or after heart surgery (postcardiotomy group). The researchers found that overall 1-year survival, regardless of subsequent heart transplantation or device removal, was 51.6 percent in the primary device group and 30.8 percent in the postcardiotomy group. For patients in the 2000 through 2005 groups, the average Medicare payment to hospitals for inpatient care in the first year after implantation of a ventricular assist device was $144,298 per patient. One-year Medicare payments for inpatient care of primary device patients totaled approximately $228 million, and was about $151 million for inpatient care of postcardiotomy patients.
 
Read abstract.
 

The median deductible required by employers for individual coverage in PPO health plans jumped to $1,000 in 2008, up from $500 last year, according to the National Survey of Employer-Sponsored Health Plans. This survey is conducted annually by Mercer, a global consulting firm.

In 2000, only about half of employers imposed a deductible for PPO coverage (compared to about four-fifths today) and when they did the median amount was just $250.  PPOs are the most popular type of health plan, enrolling 69 percent of all covered employees. What makes this finding more dramatic is that it refers to traditional PPOs--not the high-deductible health plans where a deductible of at least $1,100 is required in order to deposit tax-free money in a Health Savings Account, or HSA. These plans are spreading rapidly as well.

The Mercer survey includes private and public employer health plan sponsors with 10 or more employees. Nearly 2,900 employers participated in 2008.

Read a summary of the survey results.