Author + information
- Aaron D. Kugelmass,
- David Cohen,
- Phillip Brown,
- Matthew Reynolds,
- Marc Katz,
- Michael Schlosser and
- April Simon
Background: Proposed episode payment model (bundle) for acute myocardial infarction (AMI) necessitates understanding resource consumption. This study identifies resource consumption of Medicare beneficiaries (MBs), index hospitalization and 90 day post discharge, who sustained an AMI in FY 2014.
Methods: This study utilized 2014 Medicare Files for hospitals, post-acute care facilities, home health care services and outpatient visits. The study sample is 143,286 MBs with AMI and discharged alive. Medicare claims for each type of service occurring within 90 days of the index AMI discharge were summed for each MB.
Results: 143,286 MBs were discharged alive following their first AMI hospitalization Q1-Q3, 2014. Average Medicare reimbursement per MBs during the 90-day bundle was $20,397. The table indicates that MBs undergoing a PCI has higher Medicare reimbursement in their index hospitalization and for outpatient visits. However, MBs treated medically consumed nearly twice as much for all other services-readmission, post-acute care and home health. MBs undergoing PCI in their index AMI had a significantly lower mortality rate at 90 days 2.1% vs 7.6%, than those initially treated medically, suggesting important clinical differences.
Conclusions: This study provides benchmark data on Medicare reimbursement during the 90 days included in an AMI bundle. Further understanding of distinct patient subpopulations (PCI vs medical Rx) and drivers of resource consumption is warranted.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1253-325
- 2017 American College of Cardiology Foundation