Impact of Mobile Cardiac Outpatient Telemetry Post-Transcatheter Aortic Valve Replacement on Costs and Outcomes: A Medicare Claims Analysis
This was a retrospective study using claims files of 4161 Medicare patients undergoing TAVR procedures from 2017 to 2020.
283 patients from this cohort had post procedure MCOT monitoring.
Primary outcomes assessed were average costs, payments, contribution margins, pacemaker insertions, and length of stay were analyzed for patient undergoing AVR procedures with MCOT monitoring post procedure compared to no MCOT monitoring.
283 patients from this cohort had post procedure MCOT monitoring.
Primary outcomes assessed were average costs, payments, contribution margins, pacemaker insertions, and length of stay were analyzed for patient undergoing AVR procedures with MCOT monitoring post procedure compared to no MCOT monitoring.
Highlights:
- The use of MCOT was associated with lower hospital hospital costs and improved hospital contribution margins of the index TAVR admission(Costs: $40,569 MCOT vs $43,289 non-MCOTOT)
- No difference in Medicare payments were observed between the two groups for the index TAVR admission and for the subsequent 60-day period.
- In a subgroup analysis of patients with a heart block or conduction delay diagnosis at time of discharge, use of MCOT was still associated with an increased rate of pacemaker insertion compared to no MCOT.
- The study results demonstrate that MCOT may serve as a valuable, cost neutral tool for improving post-TAVR arrhythmia management.
Prescribing MCOT to patients post-TAVR may provide an opportunity for improved health outcomes or cost savings by monitoring for arrhythmia disturbances, and if detected, allowing for timely intervention via pacemaker and the avoidance of costly and dangerous emergency care.
Ambulatory cardiac monitoring post-TAVR discharge is associated with higher rates of pacemaker insertion, at no overall greater costs.
MCOT post-TAVR reduces patient leakage for needed interventions-none of the MCOT patients were admitted to another facility or ED for a pacemaker implantation(0% MCOT vs 18% non-MCOT)
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