Retrospective data analysis from the CHAMPION clinical trial shows significant reduction in 30-day hospital readmission rates for heart failure patients age 65 and older treated with the CardioMEMS HF system (St Jude Medical). The trial looked at the safety and effectiveness of the device for patients with New York Heart Association (NYHA) Class III heart failure who had been hospitalised for heart failure in the previous 12 months.
The analysis – “Impact of wireless pulmonary artery pressure monitoring on heart failure hospitalisation and all-cause 30-day readmissions in Medicare-eligible patients with NYHA class III heart failure” – was presented during the American Heart Association Scientific Sessions (AHA, 15-19 November, Chicago, USA).
The analysis looked at patients 65 and older (Medicare-eligible) from the CHAMPION trial and found that there was a 58% reduction in all-cause hospital readmissions (hospitalisation for any reason) and a 78% reduction in heart failure hospital readmissions when patients were managed with the CardioMEMS HF system compared to standard-of-care medical management. These findings suggest that use of the CardioMEMS HF system can significantly reduce the hospital’s risk of government-imposed penalties that are designed to reduce patient readmissions within 30 days of treatment.
The CardioMEMS system uses a miniaturised, wireless monitoring sensor that is implanted in the pulmonary artery during a minimally invasive procedure to directly measure pulmonary artery pressure. Measuring pressure allows clinicians to proactively manage treatment with medication changes for patients with worsening heart failure before visible symptoms, such as weight and blood pressure changes, occur. The system allows patients to transmit pulmonary artery pressure data from their homes to their health care providers, who then manage appropriate medication changes to reduce the likelihood of hospitalisation.
Under the US Centers for Medicare and Medicaid Services (CMS) Hospital Readmissions Reduction Program, hospitals with excess all-cause 30-day readmissions (a hospital specific CMS adjustment compared with the national average) for heart failure, heart attack and pneumonia discharges were penalised US$227m in the 2014 fiscal year. The penalty fees list in 2015 will also include chronic obstructive pulmonary disease, total hip and total knee replacement and the estimated penalties are projected at US$428m. The hospital penalties extend across total Medicare payments based on the performance of these specific conditions.
“The adoption of this treatment strategy using the CardioMEMS HF system addresses the unmet need within the US health care system for hospitals struggling to meet the requirements of CMS,” says Philip Adamson, medical director of the Heart Failure Institute at Oklahoma Heart Hospital in Oklahoma City.