In what officials are calling the “single greatest advance at Bayonne Medical Center, clinically and economically, in two decades,” Bayonne Medical Center has been included in a pilot study allowing it to perform elective angioplasty – a treatment that allows doctors to treat patients with plaque-clogged arteries to prevent heart attacks.
Angioplasty is a procedure in which doctors thread a tube through an artery to access the heart in order to install a device that will keep the coronary artery from collapsing to avoid a possibly fatal heart attack.
BMC won a very heated completion throughout the state and will be allowed to participate in a safety study that could impact hospitals throughout the nation.
Currently, patients seeking angioplasty treatment are required to go a regional cardiac center once a local hospital has issued a diagnosis of heart attack. This is not only frequently inconvenient to the patient, but denies local hospitals revenue they might otherwise have had by offering treatment.
Patients must go to regional centers because hospitals that currently perform the procedure must have a surgical back up team in place in the rare instance that the artery in which the tube has been installed ruptures.
In order to determine if the backup surgical team is necessary, the New Jersey Department of Health has joined the Departments of Health in other states in a pilot study that would allow certain hospital – of which Bayonne Medical Center – to perform the “non-evasive” procedures without the need for a back up surgical unit.
The outcome of the study – called the Atlantic C-Port-E study – could allow community hospitals to perform the procedure without incurring the cost of having a back up surgical team.
While the study has become something of a political football among the state’s hospitals, because of the fierce completion to be included in the study, proponents of the study claim that freeing hospitals from the need for a backup surgical unit could save many more lives than those risked by a possible artery rupture.
Many people, who once diagnosis with heart disease cannot be bothered to travel to a hospital outside their community, cannot afford to the higher costs associated with having the backup in place, or are unable to travel.
Because BMC has been selected for the pilot study, patients can have the procedure done there.
This has a double benefit financially: one for the patient, another for the hospital.
If the study shows as many expect that the procedure is safe to perform at hospitals without the backup unit, many more local hospitals will provide the service increasing the potential number of lives saved.
Clinical studies have also showed that the procedures a hospital does, the better its safety record becomes for that procedure.
Under the terms of the study, patients must agree to participate after being informed of the risks. Those patients considered high risk must still go to regional centers. If the study shows that elective angioplasty without a backup surgical team is unsafe, the study will be terminated, state officials said.
Living up to its potential
For Bayonne Medical Center, the chance to participate in the pilot study helps the hospital live up to its own potential.
Robert H. Evans, president and CEO of Bayonne Medical Center the hospital changed its name to “medical center” a few years ago to “better reflect the increasing complex care” that was being administered. Following the name change, Bayonne Medical Center launched a Vascular Center – headed by interventional specialist Peter Smith, M.D. which focused on developing “an entirely new line of state of the art clinical procedures” as well as developing a new revenue stream and treat more residents closer to home.
In response to questions, Evans said. open-heart surgery is on the decline thanks to new advances in medicine.
“Angioplasty as a treatment option is on the increase,” Evans said. “Specifically, drug therapy combined with angioplasty and stenting is reducing the need for the more traumatic, riskier open-heart surgery. As time goes on, this trend will continue to increase with great benefit to patients who can avoid open-heart surgery.”
Some, Evans said, have called angioplasty “the future of medicine.”
“Here in Bayonne, we recognized this move to less invasive medicine and built a state-of-the-art vascular center long before most other facilities,” Evans said. “If we had failed to earn the right to point the facility in this direction, towards Angioplasty, then we would have risked the very existence of the medical center in the years to come.”
Evans said tertiary facilities and other competitors would have eventually absorbed the hospital’s patient base and marginalizing the Medical Center.
Economically, participation in the pilot program, Evans said, places BMC in an excellent position to grow and prosper in the years to come.
“If we were shut out of this program, it would have been devastating to our organization because we would have been on the sidelines as medicine advanced,” he said. “This win gives us a seat at the table and the possibility to build a very large revenue stream in a key discipline – cardiology.”
Evans said economically viable hospitals across the state usually have a very strong cardiology program.
“This program is part of a multi year strategy to bring new, highly reimbursed services that are needed by the community in to Bayonne Medical Center,” he said. “This is not a panacea, as very real problems do exist in all areas of healthcare today. However, it is another victory and another milestone in the path to securing the clinical and economic future of Bayonne Medical Center for our current patients as well as future generations.”
Once Evens heard about the pilot study, he and his staff fought against significant odds to make certain BMC got named.
“Our Board Chairman, Herman Brockman, immediately realized this was a program that had to end up here in Bayonne,” he said.
Brockman, in fact, helped steer the BMC to acceptance despite fierce competition throughout the state.
Why high profile programs like this are important
Over the last year, union leaders and community members have accused the hospital of seeking these high profile medical treatments while meat and potato programs such as the psychiatric center and senior center were cut back.
“I can certainly appreciate and respect their perspective, as these are very challenging times in all of healthcare,” Evans said. “However, Bayonne Medical Center, like virtually every other hospital in the state, faces a very unfriendly economic environment. Reimbursements have been reduced while costs have continued to soar in all areas – pharmaceuticals, technology, fuel, insurance and so on. At the same time, third party payers have consistently reduced payments – year after year – for programs or interventions that have been traditional hospital staples. Presumably, the global thinking is that these services should be performed either as an outpatient or as an outpatient and by a less costly provider.”
Evans said the current economic environment requires institutions like the BMC to preserve its larger mission and the ensure its economic viability for now and the future by having these more advanced programs that third party providers cannot offer.
“These are both needed in the community and reimbursed more appropriately,” he said.
By providing high profile programs such as the elective angioplasty the medical center can afford to operate some of the more traditional programs at a loss – although he said he hopes that in the near future community providers such as BMC will get reimbursed more fairly.
“In the meantime, we as healthcare leaders will have to continue to make difficult, sometimes unpopular decisions in the short term to protect the larger mission,” Evans said.
Contact Al Sullivan at asullivan@hudsonreporter.com