Key result
Shifting treatment of worsening heart failure from inpatient to outpatient settings could save Medicare US$667.5 million to US$2.098 billion annually depending on the proportion shifted.
Why the study?
The study aimed to quantify potential cost savings to Medicare from shifting the site of treatment for worsening HF from inpatient to outpatient settings.
Does shifting treatment of worsening heart failure from inpatient to outpatient settings reduce costs for Medicare?
Cross-Sectional (n=151,908)
Does shifting treatment of worsening heart failure from inpatient to outpatient settings reduce costs for Medicare?
Shifting the treatment of worsening heart failure from inpatient to outpatient settings could yield significant cost savings for Medicare, ranging from $667.5 million to over $2 billion annually.
Estimated Medicare savings from shifting select worsening HF episodes to outpatient care require validation; leaves open net clinical impact.
PURPOSE: The aim of this study was to quantify the potential cost savings to Medicare of shifting the site of treatment for worsening heart failure (HF) from inpatient to outpatient (OP) settings for a subset of worsening HF episodes among the Medicare fee-for-service (FFS) population. MATERIALS AND METHODS: A cross-sectional analysis of a random 5% sample of 2014 FFS Medicare beneficiaries was conducted. Incidence and cost of worsening HF episodes in both inpatient and OP settings were identified. These results were used to calculate cost savings associated with shifting a proportion of worsening HF episodes from the inpatient to OP settings. RESULTS: A total of 151,908 HF beneficiaries were identified. The estimated annual cost for the treatment of worsening HF across both inpatient and OP settings ranged from US$9.3 billion to US$17.0 billion or 2.4%-4.3% of total Medicare FFS spend. The cost saving associated with shifting worsening HF treatment from inpatient hospital setting to OP settings was US$667.5 million or 0.17% of total Medicare spend when 10% of HF admissions were targeted and 60% of targeted HF admissions were successfully shifted. The cost savings increased to US$2.098 billion or 0.53% of total Medicare spend when 20% of HF admissions were targeted and 90% of targeted HF admissions were successfully shifted. CONCLUSION: Treatment options that can shift costly hospital admissions for worsening HF treatment to less expensive OP settings potentially lead to significant cost savings to Medicare. Pursuit of OP therapy options for treating worsening HF might be considered a viable alternative.
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Fitch et al. (2018) conducted a cross-sectional in Worsening heart failure (n=151,908). Shifting treatment from inpatient to outpatient settings vs. Inpatient management was evaluated on Cost savings to Medicare. Shifting treatment of worsening heart failure from inpatient to outpatient settings could save Medicare US$667.5 million to US$2.098 billion annually depending on the proportion shifted.
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