California Elective PCI Program Update on Application Process
As we have reported in past blogs, California law now allows 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 in law provides an opportunity for hospitals to add a service that can significantly impact the health of the population they serve and the convenience of receiving services, while providing real potential for positive financial outcomes for the organization. Spin-off benefits relating to organizational reputation and growth in other services is also a real possibility.
The California Department of Public Health (CDPH) held a webinar on May 29 to formally go over the required application and formal process and field questions from the audience. Applications are available for download at http://www.cdph.ca.gov/programs/LnC/Pages/PCI.aspx along with the final California Senate regulation.
Anyone interested in applying should download the application and begin their internal process for evaluating the feasibility of applying for certification in the new program. Some salient points that came out of the webinar are as follows:
Hospitals can submit applications any time after May 29. Although the law was intended to accept an unlimited number of qualifying applicants, into the future, technically the current authorizing law sunsets at the end of 2015. Therefore, to be on the safe side, applications should be submitted as soon as possible.
Applications are handled on a first-submitted-first-reviewed basis. It was made clear that hospitals submitting applications will need to be site-visited before a recommendation is made of approval from the site-review team. Given the limited availability of the site review team, this could create scheduling problems that will significantly lengthen the total review and approval process. Again, time is of the essence if implementation is expected in 2015.
The applicant must prove, to the satisfaction of CDPH, validated upon site visit, that it can achieve a total volume of 200 elective and primary PCI’s per year once approved. A detailed plan and supporting data must be submitted that documents the number of procedures the applicant expects to perform annually and where the patients will come from. This documentation is critical. Failure to achieve minimum volumes at acceptable quality levels could initiate program de-certification.
Primary operators must meet minimum volume standards of greater than 50 PCI’s per year (averaged over two years) at acceptable minimum quality standards. Other quality metrics and performance standards are specified.
Rigorous quality assurance and NCDR® data reporting requirements are specified to monitor and maintain quality outcomes.
The remainder of the 28-page application specifies exact requirements and necessary documentation that must be provided to CDPH to process the request for certification.
Interested in learning more about this regulatory change, the application process and how it may benefit your hospital? Please call a member of the CFA team at (949) 443-4005 for a further discussion of this important opportunity. As a California-based, CV Services-exclusive consulting services provider, CFA can help you and your organization with advice and/or direct assistance throughout the application and implementation process.
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