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Medicare Expands Defibrillator Coverage ..."IF"

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ElsewheresDaughter Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jan-28-05 10:54 AM
Original message
Medicare Expands Defibrillator Coverage ..."IF"
About 500,000 Medicare beneficiaries can now receive coverage for expensive defibrillators if they agree to release details about their cases to a database shared by hospitals, Medicare officials said

http://story.news.yahoo.com/news?tmpl=story&cid=541&nci...

<snip>

Private insurance providers applauded the decision because the government in essence endorsed making a database now shared by hospitals the basis for insurance coverage. That system, insurers say, would better direct the best treatment to the right people, improve care and save money.


Karen Ignagni, president and chief executive of America's Health Insurance Plans, called the decision an important step toward a health care system based on documented evidence of specific therapies.


"We hope that today's announcement paves the way for future post-marketing surveillance of medical devices and drugs," she said.


The Medicare agency is accepting public comment before a Feb. 14 forum by its Council on Technology and Innovation as it drafts guidelines on linking coverage to data collection.

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ismnotwasm Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jan-28-05 11:00 AM
Response to Original message
1. Hmm, seems strange
I know under HIPPA, certain information can be shared for studies as long as patient privacy is protected, but this seems like blackmail, the way it's worded. I wonder what other conditional treatments there are?
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nothingshocksmeanymore Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jan-28-05 11:04 AM
Response to Reply #1
2. 2nd paragraph
Edited on Fri Jan-28-05 11:04 AM by nothingshocksmeanymo

"It's done in a way that preserves patient confidentiality," said Mark B. McClellan, administrator of the Centers for Medicare and Medicaid Services, which administers Medicare and sets the terms of coverage. The data, he said, could help the medical community determine who is most helped by the device.

I think that this information is useful and necessary to determine efficacy of care and guidelines for who actually is a candidate for said procedure. A lot of fraud occurs on the medical side that bleeds medicare of funds and it is almost guaranteed that anyone with arrythmia will now become a defib candidate if there is NO impression that someone is watching.

edited for spelling
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Warpy Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jan-28-05 11:05 AM
Response to Original message
3. There's a huge debate right now
over the effectiveness of ICDs versus drug therapy alone. They need to collect the data on this to determine whether on not these ferociously expensive devices are helping or hurting, and which patient populations derive the most benefit from them.

Sometimes Medical Big Brother can be benign. This might be one of those cases.

...Warp, RN
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ismnotwasm Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jan-28-05 11:56 AM
Response to Reply #3
4. I worked in long term care for a long time
Just my own anecdotal experience, the ICD's only postponed the inevitable, much like drug therapy in certain cases. One patient's wife told me he was shocked three times one night. I work in acute care now, but we were starting to see these devices in LTC. It costs about ten grand for the device alone, so add in implantation costs and maintenence... you are probably right
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mtnester Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jan-28-05 06:01 PM
Response to Reply #4
6. That "inevitable" you are talking about amounts to a couple extra years
for my Grandpa, who had an ICD implanted last summer. His cardiologists told him 2-3 years max...however, without it he might not make it through the winter. He has the old style stents in from his bypass, so cannot go through another one.

Thankfully, due to delaying the "inevitable" he is now able to help see his wife, my grandma, through her new battle with newly discovered cancer, and will most likely be there for her when she passes. I, personally, am grateful to put off that "inevitable" for as long as possible. They have been together 64 years, and also just lost a daughter tragically this summer past (my mother), so they really need each other right now.

These are family, loved ones...other than his failing heart, he is in fantastic shape, and looks 20 years younger than his spry 85. He still works part time as well.

ICD's expensive? Too bad.

Sorry to rant on your post, but you aren't talking about your Grandpa, but mine.
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TahitiNut Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jan-28-05 06:16 PM
Response to Reply #4
7. Uhhm... I think "postponing the inevitable" is what health care is about.
I guess I'd have a hard time defining it differently. :shrug:
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NashVegas Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jan-28-05 05:51 PM
Response to Original message
5. Would Anybody Like to Guess Which Senate Majority Leader's Family
Edited on Fri Jan-28-05 05:57 PM by Crisco
Has two seats on the board, and one principal owner of a company that sells defibrilators?

hint, hint:

http://www.lifeguardmed.com/about_corp_officers.html
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bettyellen Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jan-28-05 06:26 PM
Response to Reply #5
8. wow they are lousy with Frists, so that's what it takes to get Medicare to
agree to pay for something. :shrug:
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NashVegas Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Jan-28-05 06:34 PM
Response to Reply #8
9. On Second Glance
Lifeguard sells external defibrillators.

oops.
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