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The Surge

Clinical, training, product and patient outcome resources for cardiac surgeons and their heart team partners

Medical Professional touching digital screen with a heart
Medical Professional touching digital screen with a heart
Medical Professional touching digital screen with a heart
August 16, 2024

Strong reimbursements enable surgeons and patients to consider innovative solutions

Doctor looking at chart
Doctor looking at chart
Doctor looking at chart

With robust commercial insurance reimbursements and a generally upward trajectory of Medicare reimbursements, cardiac surgical valve procedures remain a strong service line for US hospitals.

These trends are also encouraging for surgeons and their patients. They allow for more comprehensive discussions around valve options and technology, ensuring more appropriate options are likely to be included.  

With shared decision-making being a focal point of the latest guidelines,1 the vital role surgeons play has become even more essential. 

Increasing reimbursements for surgical valve procedures2

Medicare has historically been the most common payer among surgical valve repair and replacement procedures and has recently released its reimbursement rates for FY 2024.

Medicare Severity Diagnosis Related Group (MS-DRG) payments for surgical valve procedures have increased by 27.2% since 2016, enabling surgeons and patients to consider innovative solutions.

Surgical valve Medicare national average payments3

(weighted average of MS-DRGs 216 -221)

Surgical valve Medicare national average payments
Surgical valve Medicare national average payments
Surgical valve Medicare national average payments

†FY 2024 Weighted average inclusive of newly created DRG 212 (concomitant aortic and mitral procedures).

Medicare FY 2024 national average base payment rates3

Medicare FY 2024 national average base payment rates
Medicare FY 2024 national average base payment rates
Medicare FY 2024 national average base payment rates

In the Inpatient Prospective Payment System final rule for FY 2024 Medicare has introduced a newly created MS-DRG 212 for concomitant aortic and mitral valve procedures.

Commercial insurance payments are higher than Medicare

Cardiac procedures, particularly surgical valve procedures, can positively contribute to hospital margins. Medicare payments are strong across all MS-DRGs associated with surgical valve procedures.

However, commercial payments for these procedures are higher than Medicare payments. Additionally, the payer-mix may shift in the future as transcatheter treatment options continue to evolve.3,4

National payer mix for surgical valve procedures5

National payer mix for surgical valve procedures
National payer mix for surgical valve procedures
National payer mix for surgical valve procedures

How much higher are commercial payments (age< 65years) vs Medicare for valve procedures?6,7

How much higher are commercial payments (age< 65years) vs Medicare for valve procedures?
How much higher are commercial payments (age< 65years) vs Medicare for valve procedures?
How much higher are commercial payments (age< 65years) vs Medicare for valve procedures?

SAVR = Surgical aortic valve replacement, SMVr = Surgical mitral valve repair, SMVR = Surgical mitral valve replacement

The reimbursement landscape is evolving, and surgical valve procedures stand to benefit. Medicare’s recent guidance ensures that reimbursement updates accurately mirror the evolving treatment landscape, providing necessary treatment for patients needing simultaneous/concomitant valve repair and replacement during the primary procedure.

Lastly, the rise of patients with commercial insurance may contribute to increased reimbursement for the surgical valve service line among US hospitals.

Trends like these make it increasingly possible to consider innovative technologies that address patients' clinical needs and meet their shared decision-making priorities.

Explore all available technologies with your patients to select the most suitable option that aligns with their values, preferences, and goals.

Get our helpful guide to review reimbursement by payer class (Medicare, Commercial, & Medicaid) and understand payer-mix for surgical valve procedures.

Important- Please Note: This information is provided as a general resource and is not intended to constitute medical advice or in any way replace the independent medical judgment of a trained and licensed physician with respect to any individual patient needs or circumstances. Coverage, reimbursement, and health economics information provided by Edwards is gathered from third-party sources and presented for illustrative purposes only. This information does not constitute reimbursement or legal advice, and Edwards makes no representation or warranty regarding this information or its completeness, accuracy, or timeliness. Laws, regulations, and payer policies concerning reimbursement are complex and change frequently; service providers are responsible for all decisions relating to coding and reimbursement submissions

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References

  1. Otto CM, Nishimura RA, Bonow RA, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circ 2021;143(5):e72-e227.
  2. Agency for Healthcare Research and Quality (AHRQ). Healthcare Cost and Utilization Project (HCUP) 2019 National Statistics, Payer-mix data.
  3. Commercial, Medicare and Medicaid data: National Inpatient hospital dataset of all-payor data from 241 facilities (October 2020 to September 2021).
  4. FY 2016, ’17, ’18, ’19, ’22, ’23, 'and 24 Final rules and FY 2020, ‘2021 IPPS Final rules – Correction Notice.
  5. Agency for Healthcare Research and Quality (AHRQ). Healthcare Cost and Utilization Project (HCUP) 2019 National Statistics, Payer-mix data.
  6. Mori M, Gupta A, Wang Y, et al. Trends in Transcatheter and surgical aortic valve replacement among older adults in the United States. J Am Coll Cardiol. 2021 Nov;78(22):2161–72.
  7. Sharma T, Krishnan AM, Lahoud R. National trends in TAVR and SAVR for patients with severe isolated aortic stenosis. J Am Coll Cardiol. 2022 Nov;80(21):2054-56.

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