Acute coronary syndrome pathways: alignment with a bundled care reimbursement model

Crit Pathw Cardiol. 2011 Mar;10(1):1-8. doi: 10.1097/HPC.0b013e318211bb08.

Abstract

Changes in public policy, population demographics, and market dynamics are spurring innovative approaches to value-based care. Annually, hospitalizations for Acute Coronary Syndromes (ACS) account for a substantial proportion of healthcare expenditures in the United States. Vanderbilt University Medical Center has developed a framework to deliver comprehensive care incorporating inpatient and outpatient care teams for patients with ACS under an episode-based, bundled reimbursement model for a term of 6 months. As such, a value-oriented pathway was created with the goals of (1) optimizing patient outcomes following ACS; (2) minimizing complications from the treatment of ACS; and (3) reducing costs of healthcare related to the treatment of ACS. In a tertiary care academic medical system receiving patients from multiple facilities involving multiple providers, standardization of care by using practice guidelines and evidence-based data coupled with a robust computerized provider order entry system provides a unique opportunity to produce a "best practice" algorithm for treating patients presenting with ACS. Presented in this study are in-hospital and postdischarge care pathways for treating a diverse group of patients presenting with ACS to our institution.

MeSH terms

  • Acute Coronary Syndrome / economics*
  • Acute Coronary Syndrome / therapy*
  • Angioplasty, Balloon, Coronary
  • Critical Pathways
  • Episode of Care
  • Evidence-Based Medicine
  • Humans
  • Inpatients*
  • Outpatients*
  • Patient Care / economics*
  • Reimbursement Mechanisms*