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Select Hospitals Offering Alternative to Heart Transplants

Cheryl Clark, for HealthLeaders Media, November 18, 2009

The northern part of California, western Nevada, and southern Oregon now have a hospital that can implant "destination" heart pumps for patients who, because of other conditions or diseases, aren't eligible for a heart transplant.

With the certification granted by the Joint Commission last month, Sutter Medical Center in Sacramento became one of five hospitals in California to be certified, the only way the facility is eligible for federal reimbursement for the procedure.

Medicare's base payment for the device to Sutter is $140,512 per unit. And on average, according to a Medicare spokeswoman, the payment is $135,523.

At the same time, the 306-bed Sutter also regained approval to revive its heart transplant program, which had been discontinued by the Centers for Medicare and Medicaid Services because it did not meet the minimum number of transplants now required by Medicare.

The pumps, called ventricular assist devices or VADs, are usually used only for congestive heart failure patients as a bridge to recovery after heart surgery, or as a bridge to transplant while they are wait-listed with the United Network for Organ Sharing for a suitable donor heart.

With destination VAD implantation, many patients who are too sick for a heart transplant can benefit from a longer, better quality of life. The device enables most to live independently, away from a hospital bed. Without the device, their health continues to painfully worsen, with many expensive readmissions back to the hospital.

"They'd die in the hospital, or at home on hospice," says Kelley Jaeger-Jackson, Sutter's nursing director for transplant and ventricular assist device program.

But with implantation of destination therapy devices, instead of staying in the hospital waiting for a heart, they can be discharged home with the devices implanted and live relatively normally.

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