State committee to review cardiac cath surgery link

A statewide committee is launching a review of whether elective angioplasty must be coupled with open heart surgery, just as Metro Health Hospital’s application for those services moves on to the Michigan Department of Community Health.

Michigan is one of 13 states that requires a hospital to have open heart surgical services in order to provide elective cardiac catheterization, said Dr. John Key, of Metro Heart & Vascular, the group of cardiologists associated with Metro Health.

A Standards Review Committee is expected to begin meeting soon, and one of its duties is to recommend to the Michigan Certificate of Need Commission whether “cardiac catheterization services should be allowed at facilities that do not provide on-site open heart surgery services.”

Last week, the Evaluation Board of the Alliance for Health, the health care planning agency for 13 West Michigan counties, recommended that MDCH CON staff turn down Metro Health’s request. Board members decided that Metro Health had failed to show it could meet the current minimum standard of 300 annual open heart surgery cases by the third year of the program.

However, the board urged the CON Commission to review the methodology that hospitals use to estimate cases. Metro Health indicates that the hospital data, combined with promised physician referrals, would amount to more than 500 cases per year. But current standards consider only data based on hospital inpatient admissions.

Metro Health Planner Ken Nysson told Evaluation Board members that the hospital intends to take its application through the appeal process, should it meet rejection at the staff level.

If that is not successful, Key said “the Plan B is to approach the CON the next time when the regulations for open heart come up for review. We will push for change in the standards, in the methodology.”

Currently, Metro Health is allowed to do only emergency catheterization. Spectrum Health is the only hospital in Kent County authorized to perform the full range of cardiac procedures. Key told Evaluation Board members that Metro Health doctors perform about 250 elective catheterizations annually at the Meijer Heart Center.

Key and Randy Wagner, COO at Saint Mary’s Health Care, said that should the application succeed, the two hospitals would run the heart program together, possibly as a joint venture. Saint Mary’s parent organization, Trinity Health, is supporting the program. Sister hospital St. Joseph Mercy Health System of Ann Arbor would supervise the launch of the program, and Borgess Medical Center in Kalamazoo and the University of Michigan Health System would be advisors, as well.

In addition to Spectrum, Mercy Health Partners — another Trinity Health hospital — also provides open heart surgery. Together, the two perform 1,250 procedures annually. Spectrum performs more than 900 heart surgeries annually, making it the busiest program in the state.

At an Alliance for Health public hearing earlier this month, Spectrum Health officials argued that by taking away part of its volume, a program at Metro Health would depress quality measures in both locations.

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