Expansion of Heart Failure Device Therapy Into a Rural Indigent Population in Louisiana: Potential Economic and Health Policy Implications

Research regarding the use of implantable devices in patients with congestive heart failure (CHF) has shown mortality benefits. The Center for Medicare and Medicaid Services (CMS) approved new criteria for expanding coverage for such therapies. The purpose of this study was to determine the percenta...

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Bibliographic Details
Published in:Journal of cardiac failure 2006-12, Vol.12 (9), p.689-693
Main Authors: Hebert, Kathy, Mckinnie, James, Horswell, Ron, Arcement, Lee, Stevenson, Lynne
Format: Article
Language:English
Subjects:
Aged
Cardiac Pacing, Artificial - economics
Defibrillators
Defibrillators, Implantable - economics
Economics
Electric Countershock - economics
Electric Countershock - instrumentation
Female
Health Care Costs
Health Policy
Heart Failure - therapy
Humans
Implantable cardioverter defibrillator
Louisiana
Male
Medicaid
Medicare
Middle Aged
Pacemaker, Artificial - economics
Poverty
Rural Population
Safety net
Uninsured
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Summary:Research regarding the use of implantable devices in patients with congestive heart failure (CHF) has shown mortality benefits. The Center for Medicare and Medicaid Services (CMS) approved new criteria for expanding coverage for such therapies. The purpose of this study was to determine the percentages of CHF patients in a rural, indigent heart failure population that would be eligible for implantable defibrillators (ICD) and cardiac resynchronization therapy (CRT) based on the new CMS criteria. The new CMS guidelines were applied to information compiled in a database for 451 CHF disease management patients, at Leonard J. Chabert Medical Center. Results show that, annually, 32% of the newly identified CHF patient population would be eligible for ICD therapy and 7.3% would be eligible for CRT therapy. Providers of health care to the indigent may lack sufficient resources for the devices and the infrastructure for device implantation and follow-up.
ISSN:1071-9164
1532-8414
DOI:10.1016/j.cardfail.2006.08.214