The CFA Perspective

Regulation Changes to Allow California Hospitals with Cardiac Cath Labs to Perform Elective Percutaneous Coronary Interventions (PCI) without Cardiac Surgery-on-Site

Posted by Peter Rastello

11/1/14 7:33 AM

Californialaw will now allow hospitals licensed to provide emergent cardiac catheterization laboratory services to perform scheduled, elective PCI regardless of the presence of cardiac surgery-on-site.  This change reflects the standard of practice in many other states and the successful results of the 2008 California Department of Public Health Services (DPHS)-sponsored Elective Percutaneous Coronary Intervention Pilot Program that concluded in its final report, “… after completing risk adjustment, pilot hospital PCI had the same composite mortality and emergency Coronary Artery Bypass Grafting rate as non-pilot hospitals.” 


This is important news for select California“cath-only” hospitals.  Hospitals once limited to only diagnosing cardiac disease or conducting STEMI PCI procedures in the cath lab now may have a potential significant elective therapeutic capability as well. PCI is a critical cardiac service that denotes increased clinical sophistication, market growth, additional volume, and revenue.  The presence of interventional cardiology can contribute significantly to hospital growth, development and utilization. 


An eligible hospital must submit an application to the DPHS to obtain certification to participate in the PCI program.  Specific terms and conditions of participation are specified in regulation, including requirements for:  institutional volume, operator volume, target door-to-response times, rigorous quality assurance, staffing, hours of operation, availability of acute care and nursing unit back-up, clinical support, medical specialty support, reporting of data, minimum equipment and supplies and other important issues.  Before submittal, interested hospitals need to evaluate the strategic, operational, clinical, financial and political feasibility of implementing a PCI program.  Such an analysis is multifaceted and important for ultimate success.


Here at Charles Franc and Associates, we have performed numerous feasibility, planning and subsequent implementation engagements for cardiac cath labs and PCI with and without surgery-on-site. We can assess feasibility, compile the necessary information, identify the critical success factors, and assist your hospital in filing an application for participation with the State.  Additionally, CFA can provide implementation assistance as well.  These services can be done efficiently and effectively within a modest budget. 


Interested in learning more about this regulatory change and how it may benefit your hospital?  Please call Charles Franc at (949) 443-4005 for a further discussion of this important new opportunity.

Topics: PCI