HCFA Headquarters - Baltimore, Maryland
The purpose of this meeting is to follow up on the May 3, 2000 HCFA Meeting on APC's and Observation Services. Following this successful meeting, both sides had decided to seek ways to research changes that could be taken to prevent closure of Chest Pain Observation Units throughout the United States. The quality performance of such units was verified by Tom Marciniak (HCFA) as well as present in recent published articles in the New England Journal of Medicine and the Journal of American Medical Association. The agenda will be as follows:
- Review of present APC's and Observation Services from both sides
- Impact of HCFA changes, relating to quality performance in heart attack care, increase in cost of care and the effect on errors from missed MI's being sent home.
- Discussion of steps possible to prevent closure of Chest Pain Observation Services. Coding problems relating to APC's will be discussed.
- Definition of Chest Pain Observation Services to include "virtual unit" outside Emergency Departments as well as other observational services (since only one third of MI's present as chest pain).
It is my intention to start the meeting by reviewing the process of present day heart attack care, how it has improved with Chest Pain Observational Services and discuss fairness in reimbursement that would reflect this understanding in such a way that efforts to reduce such services will be seen as interfering with this improvement in Quality Performance of Heart Attack Care.
Sincerely and Respectfully,
Raymond D. Bahr, MD, FACP, FACC
Medical Director
The Paul Dudley White Coronary Care System
St. Agnes HealthCare
