The Medicare and AFib Report Series
The Medicare and AFib Report Series is designed to illustrate the burden of atrial
fibrillation, and to address the four priority areas recommended by the AF Stat™
Call to Action document: policy and advocacy, management, education and quality.
Reports in this series include:
- Health Services Utilization and Medical Costs Among Medicare Atrial Fibrillation
Patients, by Avalere Health
- Medicare and Atrial Fibrillation/Consequences in Cost and Care
Medicare and Atrial Fibrillation:
Consequences in Cost and Care
Avalere Health Report Highlights Specific Steps to Improve Quality, Lower Costs of
Atrial Fibrillation Care in Medicare
Erin Sullivan, PhD of Avalere Health discusses the findings
of the 2009 AF Stat report Medicare and Atrial Fibrillation/ Consequences
in Cost and Care Erin Sullivan | PhD
of Avalere Health
Overview
Atrial Fibrillation (AFib) affects approximately 2.5 million adults, 80 percent
of whom are 65 or older.27
In the next 40 years, the prevalence of AFib is projected to more than double to
5.6 million adults.28
A common, progressive and debilitating cardiovascular disease, AFib also is very
costly to treat and manage. Given the incidence, prevalence, and life-threatening
complications of AFib increase with age, Medicare is forced to absorb a majority
of the substantial clinical and economic burden.
Avalere Health prepared the report as part of the AF Stat™: A Call to Action
for Atrial Fibrillation. The report:
- describes the burden of AFib on the Medicare program;
- illustrates the current state of AFib Medicare quality improvement efforts; and,
- identifies potential strategies to improve the quality of care and patient outcomes
for AFib patients, and reduce healthcare costs
Medicare and Atrial Fibrillation: Consequences in Cost and Care was written
by Avalere Health and funded by sanofi-aventis U.S. LLC, which is the sponsor for
AF Stat. Avalere maintained editorial control and the conclusions expressed in the
report are those of the author.
Methodology
Avalere Health consulted a variety of sources to produce this report, including:
clinical guidelines, articles from peer-reviewed journals, survey data from public
and private payers, federal government resources and publicly-available information
from professional societies.
Key Findings
- Medicare pays $15.7 billion annually, due to costly complications, to treat newly diagnosed patients.29
- Importantly, these costs are considered by some to be an underestimate since they exclude deductibles, copayments, medical costs not covered by Medicare and patients who have previously been diagnosed with AFib and are currently undergoing treatment.30
- Screening and diagnosis of AFib is limited in Medicare.31
- Treating elderly AFib patients is complex.
- AFib is not a current focus of Medicare’s current quality improvement programs.32
Key Considerations to Improve the Quality of Care for AFib Patients and Reduce Medicare Costs
The report identifies three areas to reduce overall costs and improve the quality of care for AFib patients in Medicare:
- Research and Data Collection – Build on existing data sources to evaluate current treatments and identify areas for improvement;
- Quality Improvement Activities – Deliver effective care, promote patient compliance with recommendations, reduce barriers to care; and
- Coordinate Care for AFib Patients – Increase dialogue and accountability among providers, decrease duplicative services, and center care on patient.
