Medicare Changes May Increase Access to TAVR

People with aortic stenosis and a low surgical risk became eligible for a less invasive valve replacement last summer, spurring increased demand for the catheter-based procedure called TAVR. But only a subset of U.S. hospitals, including Michigan Medicine's Frankel Cardiovascular Center, are able to offer transcatheter aortic valve replacement.

New Medicare rules have lowered procedural volume requirements for hospitals who wish to offer TAVR to their patients.

But will this truly allow more people to get a TAVR who had trouble accessing the procedure before?

"We're expanding access, but we don't yet know if it's in the right areas," says Mike Thompson, Ph.D., an assistant professor of cardiac surgery at the Frankel CVC and lead author of a new research letter in JAMA Cardiology. Thompson says new TAVR offerings in rural areas could be important, but questions the need for additional hospitals performing TAVR in already crowded markets.

"Some professional associations are concerned that the restrictions may be loosed too much," Thompson says. "As we move forward, it will be important to study which hospitals begin providing TAVR, and whether they are capable of providing it in a high quality way."

Paper cited: "Access to Transcatheter Aortic Valve Replacement Under New Medicare Surgical Volume Requirements" JAMA Cardiology. DOI: 10.1001/jamacardio.2020.0443