Hospitalists Tackle Heart Failure


News that the cost of treating cardiovascular diseases is expected to triple by 2030 comes as a group of hospitalists already are tackling the issue head on.

Vikas Bhalla, MD, a hospitalist at Emory University Hospital in Atlanta, is one of a handful of hospitalists working with the Heart Failure Society of America (HFSA) in an attempt to develop a standardized care plan for HF patients. The approach would risk-stratify patients with the condition and potentially create support protocols to work with outpatient physicians.

Theoretically, Dr. Bhalla says, more outpatient support would ultimately benefit HM by reducing readmissions.

The discussions are "in the very early stages, but we deal with [HF patients] every day," he adds. "There are cardiologists that we invite for a consult on the patients, but there is no heart failure specialist. Nowadays, we have a super-specialty. … If there's a set of guidelines, maybe we can reduce the readmission grade."

The handling of HF patients, and those suffering from other cardiovascular diseases, is even more important in the wake of an American Heart Association (AHA) policy statement last month predicting that treatment costs for cardiovascular diseases would triple to $818 billion in 2030, up from $272 billion last year. The bulk of the costs are tied to hypertension and its "downstream diseases."

If cost-cutting isn't enough, Dr. Bhalla says, hospitalists should be even more motivated to combat HF as future funding rules are likely to not reimburse physicians for readmissions tied to the original case, the so-called bundling of payments. If HM can help solve the problem of readmissions, it can reduce overall costs and improve their own charge capture as well, he adds.

"This immense cost can be at least stopped from escalating, if not decreased, by having a standard of care across the board," Dr. Bhalla says.

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