It is budget time, and the phrase of the day is “decrease expenses and increase revenue.” At the same time, DRG and APC reimbursement for cardiac services in some areas is being reduced. The Centers for Medicare and Medicaid Services (CMS) proposal is to “adopt both the HSRV cc weighting methodology and the consolidated severity-adjusted DRGs. More than 1000 hospitals in rural areas will see an average increase of 3.7 percent in FY 2007; urban hospitals will see an average increase of 3.4 percent in FY 2007. Cardiac specialty hospitals will see an average increase of only 1.2 percent in FY 2007 because of the refinements CMS is making to improve payment accuracy.” Some of the “proposed” DRG changes include:

What is the size of your cath lab facility and number of staff members? Currently, the cath lab facilities of Lancaster General Hospital are comprised of 3 multi-purpose procedure rooms (cath and intervention) and two pre-post procedure areas, one with 13 beds and one with 11 beds. We are not currently planning to expand the number of cath lab procedure rooms; however, we are planning to incorporate cardiac CT and cardiac MRI into our cardiovascular service (CV) line and then reassess our needs. Our team is comprised of 53 individuals:

Case History A 61-year-old male with no history of infarct, percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG) presented with stable CCS II angina.

Why is the CARE Act necessary and important for allied health professionals and patients? Jeff Davis (JRC-CVT): First, it is our belief that the CARE Bill will improve patient care. Secondarily, in our corner of the cath lab world, it will provide recognition of the credentials deemed appropriate for work in radiation and medical imaging, and this includes the Registered Cardiovascular Invasive Specialist (RCIS) credential.

A legislative update surrounding the CARE Bill (Consumer Assurance of Radiologic Excellence) was presented at SICP’s annual meeting and Signature RCIS Review Course. Following is some of the information that was presented at the meeting.

Maintaining hemostasis can be challenging following cardiac catheterization in small children. All vascular closure devices are contraindicated in this age group, so finding acceptable strategies for preserving hemostasis in this setting can be difficult. In 2005, we began using a new device to preserve hemostasis in the post-catheterization patient.

Reprinted with permission from Vascular Disease Management 2006;3:328–333.

This monthly column in Cath Lab Digest reviews important points of distinction in DES, from characteristics to techniques, so that physicians and cath lab professionals have valuable and relevant information about this technology.

I am the Technical Supervisor at Carolinas Medical Center (CMC) Cardiac Cath Lab in Charlotte, NC. I have worked here for 12 years and in my present position, directly manage the electrophysiology department (two suites). My good friend and colleague, Kevin Collier, RCIS and I manage the diagnostic and interventional cath lab (seven rooms) cooperatively. I received my cardiac training through the U.S. Army (your tax dollars at work) and became an RCIS (at the time, RCVT) in 1994. I completed my Bachelor of Science in Health Administration in 2005 and that same year received my fellowship in SICP.

While looking through the May 2006 issue of Cath Lab Digest, I came across a request for Joint Commission stories, and I have one to share. This was a doozy!

We occasionally have a couple of physicians who will perform transeptal procedures. Why are they doing this, and what are they looking for? — RCIS Online Review Student, Spokane Community College

Multiple new and ongoing questions from readers. Your responses are welcome! Answer or pose a question at cathlabdigest (at) aol. com.

Held in Washington, D.C., October 22–27, 2006

A reader recently asked, “With so many meetings being offered, what type of meeting should I go to and why?”