CON Application CN2207-033 - PowerPoint Presentation

1. CON Application CN2207-033

2. All Criteria are MetObjective Need formula in SHP indicates additional cath lab capacity is needed.Cardiologists agree JCMC cath labs are fullConsumers need and deserve choice. Ballad is sole provider.Consumers save money. KH lab charges about 1/4 of hospital charges.This is safe according to medical experts including American College of Cardiology.

3. Goals of CON will be AchievedImproved Access to cardiac cath services Choice of providers and site of serviceCost of cath services significantly lower for consumers

4. Karing Hearts Experts to SpeakDr. Jeff Schoondyke, M.D. Board certified cardiologist and founder of Karing Hearts CardiologyTimothy W. Attebery, DSc, MBA, FACHE Former CEO of the American College of Cardiology

5. Need Criteria in State Health Plan is MetAll 6 cath labs at Ballad JCMC are operating at 100% of the utilization threshold, indicating need for an additional cath labThis assumes all 6 labs are operationalBased on a more realistic average of 4 labs being available, utilization is 150% of utilization thresholdData and utilization standards are based on past 3 years utilization – high utilization is not a “fluke”

6. Consumer Benefits – Lower ChargesCharge comparison table on page 148Average charge for 18 different procedure codes: KH’s cath lab: $5,929.37Hospital cath lab: $26,654.77 KH’s cath lab charges are 78% lower

7. Consumer Benefits: ChoiceBallad JCMC is sole provider of cath services in PSA with population of 293,000+No choice of service sites or among hospital providers of cath – It’s Ballad JCMC or leave the service areaConsumers want and deserve better:270 pages of email and letters off support – vast majority from consumers and patients.

8. Quality & SafetyMedical experts agree cardiac cath performed in ASC cath lab without surgical backup is safe:ACC, Society for Cardiovascular Angiography and Interventions (SCAI), and CMS Accredited by AAAHC – recognized and accepted by by CMS / Medicare Will participate in NCDR – only 70% of hospital based cath labs do this

9. CON should be approvedNeed:Objective need standards in SHP are met or exceededCardiologists at JCMC cath lab confirm it is fullConsumer Benefits:Much lower chargesConsumers need and deserve a choiceQuality and Safety:Leading industry experts say cath in FS lab is safeKH cath lab will be licensed and accreditedKH lab will voluntarily participate in NCDR

10. Rebuttal Slides

11. Will Not Result in ‘Fragmented’ CareAbout 50% of caths remain in hospitalHigh risk – remain in hospitalFar more patients benefit from lower cost than do notEndorsed by ACC, SCAI and CMS

12. CT-FFRThis is NOT new technologyHas not, will not replace need for cathHas limitationsNo documented support from Cardiologists

13. No Surplus Capacity at JCMC6 cath labs operating above optimal capacity past 3 years6 labs rarely operationalIF KH uses 64% - someone else is using the remaining

14. Staffing Crisis is Not Primary Justification for ApplicationApplication began well before crisisIllustrates need for alternativesBlamed on physician treatment of staff

15. Utilization of PETLogic concerning utilization is flawedNumerous factors related to usage ratesJust because one is high, doesn’t necessarily mean overutilizing

16. Effects for Uninsured Impressive record lower income and uninsuredKari’s Heart FoundationParticipation with Project AccessPatient support during COVIDRationale for referring PET studies to JCMC

17. Ballad’s Financial Viability $3 million annual loss, likely overstated0.15% of gross revenue ($2 billion)Estimated $2 million annual savings to consumersBacktracking COPA commitments

18. ETSU and Medical Education Volume of cath reduction, minimal impactDr. Schoondyke only participantFellows are welcome to perform procedures in KH’s lab