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Mubashar A Choudry MD
 Technology
 Evidence / Guidelines
 Appropriateness
 Reimbursement
 Credentialing
Mubashar A Choudry MD | The future of interventional cardiology is bright
 Catheterization & coronary angiography
 Co-axial catheter vessel lumen expansion
 Balloon angioplasty
 Steerable wires
 Stents
 Plugs
 Valves
 Technology
 Evidence / Guidelines
 Appropriateness
 Reimbursement
 Credentialing
 Stents are a commodity
 Wires have arrived
 CTO efforts continue to evolve (a little)
 Plugs will become differentiated
 Valves are perhaps not in their infancy but at
least their adolescence
 Guidance systems will become more
sophisticated
Percutaneous Aortic Valve  Current Technique
 Structural heart disease
 Hypertension
 CHF
 Angiogenesis & Myogenesis
 Diagnostics
 Technology
 Evidence / Guidelines
 Appropriateness
 Reimbursement
 Credentialing
Mubashar A Choudry MD | The future of interventional cardiology is bright
 Online Updating
 Increasing awareness & adherence
 Trials sponsored by payers to address
issues not interesting to industry
 Technology
 Evidence / Guidelines
 Appropriateness
 Reimbursement
 Credentialing
Copyright 息2009 American College of Cardiology Foundation. Restrictions may apply.
Patel, M. R. et al. J Am Coll Cardiol 2009;53:530-553
Method of Revascularization of Advanced
Coronary Artery Disease
 Useful but evolving tools
 Main Benefit: Expanding quality
improvements efforts
 Main Risk: Used to deny reimbursement (This
will happen)
 Look for a paper by Marso and an editorial by
Blankenship in JACC:Interventions February
issue.
 Technology
 Evidence / Guidelines
 Appropriateness
 Reimbursement
 Credentialing
Mubashar A Choudry MD | The future of interventional cardiology is bright
 Not going up!
 Bundled reimbursement  ACOs coming
 Favors Heart Team approach
 My best source is the Jack Lewin Blog
 Technology
 Evidence / Guidelines
 Appropriateness
 Reimbursement
 Credentialing
 Certification is the job of ABMS
 Credentialing is local and will need to address
local circumstances
 General Principles
 Experience and current activity count
 vs 
Coverage for STEMI call requires bodies
 Competition forces reduced requirements
 Consolidation enables more restrictive requirements
 The future of interventional cardiology is
bright.
 Deregulation and a leveling off of coronary
interventions bring into question how many
interventionalists are needed and what skills
are needed.
 Consolidation produces the opportunity to
improve quality and reduce costs

More Related Content

Mubashar A Choudry MD | The future of interventional cardiology is bright

  • 2. Technology Evidence / Guidelines Appropriateness Reimbursement Credentialing
  • 4. Catheterization & coronary angiography Co-axial catheter vessel lumen expansion Balloon angioplasty Steerable wires Stents Plugs Valves
  • 5. Technology Evidence / Guidelines Appropriateness Reimbursement Credentialing
  • 6. Stents are a commodity Wires have arrived CTO efforts continue to evolve (a little) Plugs will become differentiated Valves are perhaps not in their infancy but at least their adolescence Guidance systems will become more sophisticated
  • 7. Percutaneous Aortic Valve Current Technique
  • 8. Structural heart disease Hypertension CHF Angiogenesis & Myogenesis Diagnostics
  • 9. Technology Evidence / Guidelines Appropriateness Reimbursement Credentialing
  • 11. Online Updating Increasing awareness & adherence Trials sponsored by payers to address issues not interesting to industry
  • 12. Technology Evidence / Guidelines Appropriateness Reimbursement Credentialing
  • 13. Copyright 息2009 American College of Cardiology Foundation. Restrictions may apply. Patel, M. R. et al. J Am Coll Cardiol 2009;53:530-553 Method of Revascularization of Advanced Coronary Artery Disease
  • 14. Useful but evolving tools Main Benefit: Expanding quality improvements efforts Main Risk: Used to deny reimbursement (This will happen) Look for a paper by Marso and an editorial by Blankenship in JACC:Interventions February issue.
  • 15. Technology Evidence / Guidelines Appropriateness Reimbursement Credentialing
  • 17. Not going up! Bundled reimbursement ACOs coming Favors Heart Team approach My best source is the Jack Lewin Blog
  • 18. Technology Evidence / Guidelines Appropriateness Reimbursement Credentialing
  • 19. Certification is the job of ABMS Credentialing is local and will need to address local circumstances General Principles Experience and current activity count vs Coverage for STEMI call requires bodies Competition forces reduced requirements Consolidation enables more restrictive requirements
  • 20. The future of interventional cardiology is bright. Deregulation and a leveling off of coronary interventions bring into question how many interventionalists are needed and what skills are needed. Consolidation produces the opportunity to improve quality and reduce costs