TY - JOUR
T1 - Public Health Impact of the Centers for Medicare and Medicaid Services Decision on Pass-Through Add-On Payments for Drug-Coated Balloons
T2 - A Call to Action
AU - Shishehbor, Mehdi H.
AU - Jaff, Michael R.
AU - Beckman, Joshua A.
AU - Misra, Sanjay
AU - Schneider, Peter A.
AU - Lookstein, Robert
AU - Kashyap, Vikram S.
AU - Aronow, Herbert D.
AU - Schuyler Jones, William
AU - White, Christopher J.
N1 - Funding Information:
Dr. Shishehbor has served as a consultant for Abbot Vascular, Medtronic, Boston Scientific, and Philips. Dr. Jaff has served as a noncompensated advisor to Abbott, Boston Scientific, Cordis, and Medtronic; consultant for Micell, Philips/Volcano, Venarum, and Vactronix; and is an equity investor in PQ Bypass, Primacea, Vascular Therapies, Embolitech, and Sano V. Dr. Beckman has served as a consultant for Aralez, AstraZeneca, Bristol-Myers Squibb, Janssen, and Sanofi; has served on the data safety and monitoring board for Bayer; owns equity in EMX and Janacare; and has served on the advisory board for VIVA. Dr. Misra has received research grants from the National Institutes of Health (R01 grant nos. HL098967 and DK 107870) and Boehringer Ingersoll; and has served as the data safety and monitoring board chair for Cordis. Dr. Schneider has received modest royalty from Cook Medical; and has served as the chief medical officer for and is a cofounder of Cagent and Intact Vascular. Dr. Lookstein has served as a consultant for Boston Scientific and Medtronic. Dr. Schuyler Jones has received consulting honoraria from Janssen Pharmaceuticals, Bayer, Bristol-Myers Squibb, Pfizer (all small, <$10k); research grants from the Agency for Healthcare Research and Quality, the Doris Duke Charitable Foundation, Medtronic, and the Patient-Centered Outcomes Research Institute. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2018 American College of Cardiology Foundation
PY - 2018/3/12
Y1 - 2018/3/12
N2 - On Wednesday, November 1, 2017, the Centers for Medicare and Medicaid Services (CMS) made a public decision to end the transitional pass-through add-on payment for drug-coated balloons beginning January 1, 2018, without creating a new ambulatory payment classification rate for these devices. In this Viewpoint, the authors highlight the disconnect between the CMS's decision not to create a new ambulatory payment classification category for drug-coated balloons despite demonstrated clinical superiority. The authors believe this decision is more in line with a rigid fee-for-service payment system than a value-based system that encourages quality over quantity, and disadvantages both the elderly and the poor. They call on all who advocate for patients with peripheral artery disease to action, encouraging their engagement on CMS decisions regarding payment.
AB - On Wednesday, November 1, 2017, the Centers for Medicare and Medicaid Services (CMS) made a public decision to end the transitional pass-through add-on payment for drug-coated balloons beginning January 1, 2018, without creating a new ambulatory payment classification rate for these devices. In this Viewpoint, the authors highlight the disconnect between the CMS's decision not to create a new ambulatory payment classification category for drug-coated balloons despite demonstrated clinical superiority. The authors believe this decision is more in line with a rigid fee-for-service payment system than a value-based system that encourages quality over quantity, and disadvantages both the elderly and the poor. They call on all who advocate for patients with peripheral artery disease to action, encouraging their engagement on CMS decisions regarding payment.
KW - Center for Medicare and Medicaid Services
KW - drug-coated balloons
KW - fee-for-service
KW - pass-through add-on payments
KW - public health
KW - value-based system
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U2 - 10.1016/j.jcin.2018.01.233
DO - 10.1016/j.jcin.2018.01.233
M3 - Review article
C2 - 29519384
AN - SCOPUS:85042790916
SN - 1936-8798
VL - 11
SP - 496
EP - 499
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 5
ER -