Insurers Re-evaluate Reimbursement for Angioplasty

Findings from the COURAGE trial, shared last week at the American College of Cardiology Conference and published in the New England Journal of Medicine, are prompting Tennessee’s BlueCross BlueShield (BCBS) to re-evaluate reimbursement rates for angioplasty, reports the Tennessean.

A comment from the Health Policy Research Director at Tennessee’s BCBS suggested ongoing assessment of reimbursement rates in light of evidence-based studies. While his comments appear to focus on reimbursement, some clinicians are concerned about the possibility of limiting patient access to procedures, in this case angioplasty.

One of the COURAGE study authors noted the significant cost savings to the healthcare system by limiting angioplasty to patients who were unstable. The finding that leaves questions is that symptoms of chest pain seemed to be greater resolved with angioplasty. This potential benefit needs to be balanced with the significantly higher cost for angioplasty compared to medical therapy alone.

In the greater context of an overburdened healthcare system riddled with enormous spending, part of the solution is the best overall approach. Best practice guidelines issued from the American College of Cardiology and the American Heart Association account for such factors and will likely be updated as new evidence is published.

April 2, 2007 Related topics: Medical Devices & Products, Finance, Surgery, Cardiology, Standardization, Pricing

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