West Virginia's largest hospitals are lining up against the state's latest proposal to allow smaller hospitals to perform life-saving heart procedures.
West Virginia's largest hospitals are lining up against the state's latest proposal to allow smaller hospitals to perform life-saving heart procedures.
Executives at the big hospitals say the West Virginia Health Care Authority's proposed cardiac catheterization standards would put patients in danger and drive up health care costs.
The proposal would allow community hospitals to offer life-saving procedures, such as angioplasties, to unclog blocked and narrowed arteries to the heart, even though the facilities don't have backup cardiac surgery units.
Only six hospitals in the state offer open-heart surgery. Last week, three of those - Charleston Area Medical Center, St. Mary's Hospital in Huntington and Wheeling Hospital - sent letters to the Health Care Authority opposing the new standards.
"You're setting up false expectations," said CAMC Chief Executive Officer David Ramsey on Tuesday. "The quality will not be what it should be."
The Health Care Authority is reviewing comments from hospital executives across the state. The agency's board could vote on the proposed changes as early as June 11.
In 2002, the authority approved three demonstration sites - Saint Francis Hospital in Charleston, Weirton Medical Center and United Hospital Center in Clarksburg - to see whether heart catheterizations could be done without surgery backup. The agency hired a consultant to evaluate the pilot programs, and the hospitals got high marks.
Cardiologists at Saint Francis are performing about 400 artery-opening procedures a year.
"It's a procedure that can be done safely, and it can save your life," said Dan Lauffer, chief executive officer at Saint Francis. "West Virginia has the highest rate of heart disease in the nation. This can improve access."
Lauffer said 28 states already allow hospitals to perform angioplasties without on-site heart surgery backup.
Executives at the larger hospitals say smaller hospitals won't have enough patients to maintain high-quality programs.
They cite a recent American College of Cardiology/American Heart Association study that found heart patients were better off at hospitals where heart specialists perform large numbers of life-saving catheterizations - at least 400 a year.
West Virginia's largest hospitals are lining up against the state's latest proposal to allow smaller hospitals to perform life-saving heart procedures.
Executives at the big hospitals say the West Virginia Health Care Authority's proposed cardiac catheterization standards would put patients in danger and drive up health care costs.
The proposal would allow community hospitals to offer life-saving procedures, such as angioplasties, to unclog blocked and narrowed arteries to the heart, even though the facilities don't have backup cardiac surgery units.
Only six hospitals in the state offer open-heart surgery. Last week, three of those - Charleston Area Medical Center, St. Mary's Hospital in Huntington and Wheeling Hospital - sent letters to the Health Care Authority opposing the new standards.
"You're setting up false expectations," said CAMC Chief Executive Officer David Ramsey on Tuesday. "The quality will not be what it should be."
The Health Care Authority is reviewing comments from hospital executives across the state. The agency's board could vote on the proposed changes as early as June 11.
In 2002, the authority approved three demonstration sites - Saint Francis Hospital in Charleston, Weirton Medical Center and United Hospital Center in Clarksburg - to see whether heart catheterizations could be done without surgery backup. The agency hired a consultant to evaluate the pilot programs, and the hospitals got high marks.
Cardiologists at Saint Francis are performing about 400 artery-opening procedures a year.
"It's a procedure that can be done safely, and it can save your life," said Dan Lauffer, chief executive officer at Saint Francis. "West Virginia has the highest rate of heart disease in the nation. This can improve access."
Lauffer said 28 states already allow hospitals to perform angioplasties without on-site heart surgery backup.
Executives at the larger hospitals say smaller hospitals won't have enough patients to maintain high-quality programs.
They cite a recent American College of Cardiology/American Heart Association study that found heart patients were better off at hospitals where heart specialists perform large numbers of life-saving catheterizations - at least 400 a year.
The new standards would require hospitals to perform at least 200 diagnostic procedures, but only three dozen life-saving catheterizations a year.
"We just believe the standards are too low," Ramsey said.
Ramsey has urged the Health Care Authority to prohibit smaller hospitals from advertising themselves as "heart centers" or "heart-attack centers" because they can't treat all heart-attack patients and conditions.
The issue has become contentious, in part because heart catheterizations are one of the few profit-making services that hospitals offer.
In letters to the Health Care Authority, executives at large hospitals said they've invested millions of dollars in catheterization labs to diagnose and treat heart disease. They predict they'll lose patients to nearby hospitals that duplicate services.
For instance, Wheeling Hospital, which offers open-heart bypass surgery, would have to compete with hospitals only a few miles away, if Ohio Valley Medical Center in Wheeling and Reynolds Memorial Hospital started to offer life-saving catheterizations.
"Creating duplicative programs at hospitals across town will do nothing to increase access, will do everything to increase costs and, most important, will decrease quality," wrote Wheeling Hospital Chief Executive Officer Ron Violi last week.
Violi also said the proposed standards would temporarily prop up hospitals that should close.
"These standards are merely an artificial means of keeping hospitals afloat that cannot afford to compete," Violi said in his letter.
Executives at large hospitals also are upset that the Health Care Authority's proposed standards no longer require smaller hospitals to have a written agreement with hospitals that offer cardiac surgery. Patients would be shuttled to the larger hospitals if something went wrong.
Now, the standards only require that smaller hospitals have "protocols" in place - but nothing in writing - to transfer patients.
To contact staff writer Eric Eyre, use e-mail or call 348-4869.
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Kentucky went down this road about ten years ago. Bring them in, do the cath, fly them out to a higher level of care. It simply makes no sense. Take them to where they can be fixed in the first place.
Lets talk cash, shall we? Do cardiac services make money for big hospitals? You betcha. But those dollars help support things like trauma care for the uninsured ATV rider who tips some beer with his buddies and says "Hey boys, watch this!" I see them everyday. Take away those cardiac dollars and even more could change.
Every hospital has its place. Cath labs should not be in small facilities.
Last year my mother had an angioplasty procedure scheduled at Raleigh General Hospital. The doctor performed the procedure and sent my mother home the same day without correcting the blockages. Later that night she suffered a heart attack and was flown to CAMC where it was discovered that the collagen plug in her femoral artery was leaking and a huge clot had formed on the inside of the artery. Ten days later my mom came home after a near brush with death. Had she been taken to CAMC in the first place this could have been avoided.
My point is this: If the hospital does not have the ability to correct the problems that they find, they are going to do much more harm than good. Let the large hospitals take care of these most serious of conditions and let the little hospitals take care of minor issues. After all no one goes to a walk in clinic for brain surgery.