More on Reimbursement

Hospital resources strained as Medicare reimbursement for MRI-compatible cardiac devices lags

The total spend increase for CRM devices is 8 percent, which translates to a $400 million estimated cost increase for hospitals.

Jeff Lagasse, Associate Editor

MRI-compatible cardiac rhythm management devices, such as pacemakers and implantable cardioverter defibrillators, have gained significant market share in recent months -- and that's placing a growing strain on hospital resources.

A new report from Vizient finds that Medicare continues to reimburse at the rate established for standard device implants, despite their higher cost. The result is an increase in total spend for CRM devices of 8 percent based on current adoption rates, which translates to a greater than $400 million estimated cost increase for hospitals.

The Sg2 Impact of Change forecast, the healthcare industry's go-to tool to understand future utilization trends, projects the CRM device market to grow roughly 2 percent each year over the next decade, meaning this reimbursement hole will only continue to grow unless something changes.

There are certainly patients who can benefit from these devices, but understanding the data and trends can help ensure appropriate patient selection while managing overall device spend, the authors said.

An estimated 25 to 50 percent of patients with CRM devices will not require an MRI study during their lifetime. For those who do, recent data shows that a 1.5T MRI can be safely performed in patients with standard CRM devices if appropriate precautions and protocols are followed.

Plus, Vizient's data shows that MRI usage appears to peak in patients around age 60 and then declines quickly as patients enter their mid-70s. Pacemaker and defibrillator implantation, on the other hand, peaks at age 79.

The data is unclear as to whether the declining number of MRI procedures in the older population is due to lack of necessity, limitations created from implanted CRM devices or other implanted medical devices, limitations created by non-MRI labeling and/or limitations on MRI reimbursement.

Twitter: @JELagasse
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