Metro Health heart services to be profitable

July 19, 2010
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Metro Health Hospital anticipates that profits from its proposed therapeutic cardiac catheterization and open heart surgery programs would average between about $1,900 and $2,900 per case.

The hospital submitted financial estimates as part of its application to the state to perform the heart procedures in its Wyoming facility.

Dr. John Key, chairman of cardiology at Metro Health and cardiologist for Metro Heart and Vascular, said the hospital performed 63 emergency angioplasties last year.

“We are talking about angioplasty, which is ballooning the artery, and stenting,” he said. “We do it in patients coming in actively having a myocardial infarction — a heart attack.”

But the five-doctor practice funnels about 250 other heart procedures to Spectrum Health’s Frederik and Lena Meijer Heart Center on an annual basis, Key said.

That’s because state rules require that a hospital have an open heart surgery program to perform angioplasties on a non-emergency, or therapeutic, basis.

Busiest adult open heart surgery programs in 2008
Spectrum Health 952
University of Michigan Hospitals 906
William Beaumont Hospital, Royal Oak 686
Oakwood Hospital and Medical Center 651
St. Joseph Mercy, Ann Arbor 656
Munson Medical Center 644

Source: 2009 Michigan Certificate of Need Annual Survey, Open Heart Surgical Procedures

Two Metro heart and vascular doctors who are interventional cardiologists perform angioplasty and stent procedures at Spectrum. Some Metro patients are referred to cardiothoracic surgeons for open heart surgery, which must be performed at Spectrum, as well.

According to Metro Health’s application to the Michigan Department of Community Health, the hospital expects it would handle at least the minimum requirement of 300 open heart procedures or as many as 507, based on the expectation of referrals from Saint Mary’s Health Care, Mercy Health Partners and Sheridan Community Hospital.

The angioplasty and open heart programs combined would bring an estimated margin of $2.4 million by the end of 2012, compared to the $32,802 in 2009 from the current limited services, the application states.

Metro expects to spend $4 million on renovations to accommodate heart programs, if the MDCH approves its application.

“For an open heart program, we would need to redesign one of our operating rooms … in order to make it ready for open heart procedures. Certainly, we would be working very closely with cardiothoracic surgeons that perform these operations in designing and building out an operating room,” Key said.

Other accommodations would include a post-surgical unit dedicated to heart patients, as well as staff training, he added.

The application includes letters from Saint Joseph Mercy Health System in Ann Arbor and from Borgess Health in Kalamazoo agreeing to help Metro Health on the proposed design of surgical and support areas, provide recommendations on staffing and staff training, and work with medical staff and the governing body to design and implement processes to measure, evaluate and report on such clinical outcomes as mortality, complications, infections and success.

According to the Michigan Department of Community Health’s Certificate of Need’s 2009 annual survey of open heart surgical procedures, Spectrum Health handled 952 adult cases in 2008. In the same MDCH service area of West Michigan, Mercy Health Partners in Muskegon saw 286 adult procedures.

Open heart surgery is performed at 34 locations throughout the state, with Southeast Michigan hosting 17 programs that fielded 5,650 adult cases in 2008, compared to two programs for 1,238 cases in West Michigan.

Alliance for Health, the local nonprofit health planning agency, may consider Metro Health’s application this fall, President Lody Zwarensteyn said.

“The big thing about this is just giving patients and physicians options,” Key said.

“When you look at national access as far as number of programs per patients served, West Michigan is unique, not only in the state of Michigan but in the country. Right now we’ve got one program, if you just look in Kent County, for 600,000 individuals. Access-wise, I think that our service district certainly looks underutilized as far as number of programs go.”

Key said he thinks Metro Health will be able to offer a cost-effective alternative to Spectrum Health.

“Competition in most instances is a good thing. Competition usually tends to drive down costs, tends to improve quality,” he said.

The Metro Health application places the average hospital charge for therapeutic cardiac catheterization at $31,620, with an average profit of $2,906. Spectrum’s average price for hospital services related to heart vessel angioplasty, as listed on its website, is $39,300.

Metro estimated the average hospital charge for open heart procedures at $55,619, with an average profit of $1,915.

At Spectrum, procedures such as aortic valve replacement, coronary valve replacement and a three-vessel bypass generate average hospital charges between $58,500 and $98,400.

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