Related Experiment Video
Updated: Jun 2, 2026
09:20
Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Do heart failure disease management programs make financial sense under a bundled payment system?
Zubin J Eapen1, Shelby D Reed, Lesley H Curtis
1Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
American Heart Journal
|May 17, 2011
Summary
Bundled payments for heart failure (HF) care may incentivize hospitals to adopt disease management (DM) programs. These programs can reduce costly HF readmissions, making them financially viable for providers.
Area of Science:
- Health economics
- Healthcare policy
- Cardiology
Background:
- Policymakers propose bundled payments for heart failure (HF) care to reduce costs.
- Disease management (DM) programs reduce HF readmissions but are not cost-effective under current payment models.
- The financial impact of DM programs under bundled payment is unclear.
Purpose of the Study:
- Determine the cost-neutral point for typical DM programs.
- Assess if published HF DM programs are cost-saving under bundled payments.
- Evaluate the financial viability of DM programs for HF care.
Main Methods:
- Decision analytic model using retrospective data, meta-analyses, and randomized trials.
- Analysis of Medicare claims for HF discharges (2001-2004).
- Calculation of DM program and inpatient care costs over 30 and 180 days.
Main Results:
- Baseline HF readmission rate was 22.9% ($2,272 cost per patient).
- A DM program reducing readmissions by 21% needs to cost $477/patient to be cost-neutral.
- Three of five evaluated DM programs were cost-saving (-$241 to $347/patient).
- Extending bundled payments to 180 days increased savings ($419 to $1,706/patient).
Conclusions:
- Bundled payments for HF admissions can financially incentivize hospitals.
- Implementation of DM programs that reduce readmissions becomes attractive.
- This model supports cost-effective HF care management.
Related Concept Videos
01:30Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
01:30Heart Failure VII: Nursing Interventions
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
01:21Rheumatic Heart Disease III: Medical Management
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
01:29Cardiomyopathy VI: Nursing Management
Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...
01:22Heart Failure VI: Adjunct Therapies
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...