In late June, CMS issued its finalized national coverage determination (NCD) for transcatheter aortic valve replacement (TAVR). We previously wrote about the first published draft of the NCD, analyzing the expected impact on hospitals and health systems. Little content changed when the draft was finalized, and many of the takeaways from our original analysis are still applicable.
Recapping the New Rules
Two key changes that were confirmed in the finalized NCD are:
- New FDA-approved patient indicators that broaden eligibility for TAVR to lower-risk patients.
- Updated requirements for hospitals seeking to establish or maintain their structural heart programs.
What This Means for Your Organization
Establishing a New Program
- Increased access to new patient groups, combined with altered requirements, will provide new opportunities to establish TAVR programs.
Existing TAVR Programs
- Further cannibalization of existing surgical volume may harm financial performance.
- Increased TAVR volume may add to non-WRVU-generating physician activities, which will alter physician compensation.
Our original blog post looks closely at these changes and details their implications for cardiovascular programs.