Analysis shows ACOs reduced Medicare spending $755M | Interhospital partnership boosts pediatric cardiac surgery outcomes | Study analyzes hospital readmissions linked to gunshot wounds
December 5, 2019
CV Quality SmartBrief
Transforming Cardiovascular Care and Improving Heart Health
First Focus
Analysis shows ACOs reduced Medicare spending $755M
An analysis by Dobson, DaVanzo & Associates found accountable care organizations reduced Medicare spending by $755 million from 2013 to 2017. Gross savings totaled $3.5 billion over the time period before payments for quality bonuses were awarded.
FierceHealthcare (12/3) 
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Interhospital partnership boosts pediatric cardiac surgery outcomes
Researchers found that hospitals that collaborated to create the Pediatric Cardiac Critical Care Consortium aimed at improving cardiac surgery outcomes among children had 24%, 22%, 13% and 12% lower in-hospital mortality, cardiac ICU postoperative mortality, postoperative mechanical ventilation duration and major complication rates, respectively, as well as 5% shorter length of stay in the cardiac ICU than at baseline. The findings in the Journal of the American College of Cardiology showed that major complication rate, operative mortality prevalence and total duration of postoperative hospitalization in non-PC4 hospitals didn't improve during the same period.
Medscape (free registration)/Reuters (12/3) 
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Study analyzes hospital readmissions linked to gunshot wounds
A retrospective study presented at the Radiological Society of North America's annual meeting analyzed gunshot injury data from 110 emergency department patients and found that those with abdomen or chest injuries were more likely to be readmitted. "Gun violence is a national health emergency, and yet there is a profound lack of research on the long-term consequences of gunshot-related injuries," said researcher Dr. Corbin Pomeranz.
Radiology Business (12/3),  MedPage Today (free registration) (12/3) 
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Practice & Hospital Management
Study: Health system affiliation a mixed bag for rural hospitals
Operating margins at rural hospitals that affiliated with health systems increased by 1.6 to 3.6 percentage points in the first two to five years, according to a study in Health Affairs. On-site diagnostic imaging technologies, obstetric and primary care availability, and outpatient nonemergency visits decreased after affiliation, raising concerns that affiliation could reduce access to care in rural areas, the researchers wrote.
Becker's Hospital CFO Report (12/4) 
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Study links specialist shortage to mortality in rural areas
An analysis of data from Medicare beneficiaries with complex chronic health conditions showed those living in rural areas had 23% higher mortality rates and 40% higher rates of preventable hospitalizations than their peers living in urban areas. Poor access to cardiologists, endocrinologists and other specialists was the main reason for the disparity, according to the study in Health Affairs.
Healthcare Finance (12/4) 
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How health systems can help address loneliness
Social isolation and loneliness are tied to poor health, increased mortality risk and higher health care spending. Hospitals and health systems can help address these health issues by screening patients for loneliness at admission or in emergency departments, using data to understand which groups are most at risk, creating support groups to promote social connection, and promoting opportunities for volunteers, among other measures.
Becker's Hospital Review (12/3) 
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Innovation & Technology Trends
Simple EHR cue reduces duplicate imaging, lab work
Simple EHR cue reduces duplicate imaging, lab work
A checkbox outlined in red that popped up when duplicate orders were entered into a patient's EHR reduced unintended duplicate orders for laboratory tests by 49% and radiology imaging by 40%, according to the results of a study published in JAMA Network Open. The item's checkbox was highlighted in red if the order had already been placed by emergency department personnel, but it "is applicable to any care setting where clinical care teams must collaborate," researchers wrote.
Health Data Management (free registration) (12/3) 
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Prevention & Research News
Study: Treating high cholesterol earlier may reduce CV risks
Beginning treatment to reduce cholesterol levels earlier in adulthood may decrease the risk of cardiovascular disease later, researchers reported in The Lancet. Data suggested that for adults under age 45 who had at least two heart disease risk factors, lowering non-HDL cholesterol reduced later CV risks from about 16% down to 4% for women and from 29% to 6% among men.
HealthDay News (12/4),  MedPage Today (free registration) (12/3) 
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Study links maternal diabetes to future CVD risk in children
Children born to mothers with diabetes had a 29% higher likelihood of developing cardiovascular disease, especially deep vein thrombosis, hypertensive disease and pulmonary embolism, during 40 years of follow-up, compared with those whose mothers didn't have diabetes, researchers reported in The BMJ. The study found the highest increase in risk of early CVD among those whose mothers both had diabetes and CVD.
MedPage Today (free registration) (12/4),  The New York Times (tiered subscription model) (12/4) 
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Other News Highlights
Spotlight on JACC Journals
ACC News
ACC's Quality Improvement for Institutions celebrates 5 years
ACC's Quality Improvement for Institutions website, which launched in 2014, is celebrating its fifth anniversary. This platform houses the NCDR registries, ACC Accreditation Services, Quality Campaigns and Clinical Toolkits. By bringing together all of these resources together under one roof, the ACC has made it easier for facilities to access their quality data, identify areas for improvement, use clinical tools and apps, or participate in evidence-based quality campaigns. Learn more.
Study examines 30-day post-MI readmissions using data from NCDR and CMS claims
Patients readmitted to the discharging hospital after myocardial infarction do not have significant differences in outcomes compared with those readmitted to another hospital, according to an NCDR study. The study used data from ACC's Chest Pain - MI Registry and claims data from the CMS to examine patterns in 30-day post-MI readmissions, stratified by the discharging hospital vs. nondischarging hospital. Read more.
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Ansel Adams,
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This news roundup is provided as a timely update to ACC members and partners interested in quality health care topics in the news media. Links to articles are provided for the convenience of the health care professionals who may find them of use in discussions with patients or colleagues. Opinions expressed in CV Quality SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American College of Cardiology. On occasion, media articles may include or imply incorrect information about the ACC and its policies, positions, or relationships. For clarification on ACC positions and policies, we refer you to
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