November 2021 Meeting Summary

A woman attends a Zoom meeting via laptop.

Thanks to all who attended our November meetings. Did you miss a meeting or do you need a refresher? Read our summaries.

The BMC2 Vascular Surgery Collaborative Meeting was held on November 4th. We welcomed Dr. Peter Lawrence from UCLA who presented “Appropriateness in PAD Procedures: Good Results Are Not Enough.” Dr. Lawrence explained that the right patient, right doctor, right procedure, right time, right place, and right follow-up leads to appropriate vascular surgical care.  Dr. Nicholas Osborne presented, “Decision-making in Peripheral Artery Disease” and shared the importance of including patients in the decision-making process.

Dr. Abdul Kader Natour presented “Utilization of Preoperative Vein Mapping in Patients Undergoing Infra-Inguinal Bypass Is Associated With Increased Use of Vein Conduits.” When compared to national benchmarks (VQI), surgeons performing infra-inguinal bypass in BMC2 utilize both preoperative vein mapping and autologous vein conduits at a lower rate for infra-inguinal bypass. Preoperative vein mapping may be a marker for physician commitment to best practices for infra-inguinal bypass.

Dr. Krishna Jain presented “Running a Quality-Focused OBL” and shared that procedures can be performed in the office safely and with high patient satisfaction, revenue stream to the practice improved significantly, there are savings for the health care system, and every vascular surgeon should consider office-based intervention.

Dr. Craig Brown and Dr. Nicholas Osborne presented, “Perverse Incentives Drive Inappropriate Care: Insights from Office-Based Atherectomy in Michigan and the Rest of the U.S.”  Some of the mechanisms by which high utilizers are achieving a high reimbursement rate by converting more patients to atherectomies, treating a higher number of vessels per patient, and they’re deploying the catheter more times per patient. Dr. Tammy Chang from HBOM shared information on the new CQI and its mission to use teachable moments to improve patient outcomes when it comes to diet, exercise, and smoking cessation. We also had BMC2 and VQI data reviews from Dr. Peter Henke and Dr. Ash Mansour.

The PCI Webinar was held on November 18th. Dr. Devraj Sukul reviewed the 3-year data. We heard from Dr. Edouard Daher who presented, “Coronary Physiology in the Cardiac Catheterization Laboratory.” He shared that FFR guidance improved patient outcomes and makes economic sense as it reduces the risk of MACE by 28%, reduces the risk of death and MI by 34%, and results in functional class equal to or better than angio-guided PCI. It results in fewer stents used, saving $675 per patient at procedure time and more than $2000 per patient at 12 months. It also reduces contrast usage. Dr. Gurm also shared information on 2022 peer review, P4P, and VBR. This information can be found on our website. Additionally, cardiac rehab reports can now be found on the password-protected website. Please share them and discuss them with your cardiac teams.