With a shift away from inpatient care for some services, what happens to cardio revenues? Sid Kirschner, executive vice president of Piedmont HealthCare and president and CEO of Piedmont Physicians Organization, looks at patient care in pretty broad terms. "Wherever a patient enters our system, [we] have to be able to treat that person for all of their cardio needs for the rest of their life. We could get someone who is healthy and goes to a cardiologist; as time evolves, other problems develop. Our system is designed to handle all those issues."
Piedmont's wellness programs prompt early medical encounters with the population at large, maximizing the opportunities to establish relationships with patients. Does that sound like marketing? Kirschner calls it "a mutual benefit endeavor. You want to capture the patient as early as possible in your cycle. It's a combination of preventive health benefit for the patient as well as a marketing program. So now that you have the patient, as the patient ages and has a problem, the patient is in your system."
Banner Heart's Robertson observes that population characteristics support such a long-term view. "There will always be cardio patients who need procedures," she says. "Cardiac disease isn't going away. Look at diabetes incidence, the aging population, obesity. The risk factors for cardiac disease are so prevalent."
If one examines the make-up of the revenue stream, one sees continuing revenue in imaging, mostly on an outpatient basis. Says Kirschner, "If you really track reimbursement, most of the volume is outpatient testing after the first visit. You do an initial MRI or CT scan and then there is appropriate follow-up." This may be why imaging is cited by 35% of respondents as a technology they expect to add to their cardio service line in the next three years. The appeal of imaging is even stronger among smaller enterprises: 42% of organizations with net patient revenue of less than $250 million expect to add imaging technology, while just 19% of organizations with NPR of more than $1 billion will be doing so, as they focus more on remote monitoring technology (60%) and hybrid rooms (55%).