A new report from Irving, Tex-based Vizient, entitled “The Beat Goes On: Weighing Clinical Benefits, Patient Selection and Healthcare Economics of MRI-Compatible Cardiac Rhythm Devices,” discusses the financial impact on hospitals resulting from “the sudden and dramatic increase in the use of MRI-compatible CRM devices over the last 18 months.”
According to the report, magnetic resonance imaging (MRI)-compatible cardiac rhythm management (CRM) devices, such as pacemakers and implantable cardioverter defibrillators, have gained significant market share in recent months. This is putting a growing strain on hospital resources as 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%, 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% each year over the next decade, meaning that this reimbursement hole will only continue to grow unless something is done, the report’s authors note.
“The rapid growth in the use of MRI-compatible devices by physicians reflects their focus on providing enhanced patient care both short and long-term,” says Doug Beinborn, senior director, contract services at Vizient. “It also demonstrates a potential lack of understanding of the difference in device costs and the financial impact to the health care system.”
Multiple publications estimate that 25% to 50% of patients with CRM devices will not require an MRI study during their lifetime. For those who do, recent studies, including one published from the Mayo Clinic, have shown that a 1.5T MRI can be safely performed in patients with standard CRM devices if appropriate precautions and protocols are followed. Additionally, Vizient data show 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, says Beinborn. “However, given the cost impact being experienced by providers, further research is needed to better understand this decline,” he adds.
The view the full report, visit Vizient.