Why the United States Center for Medicare and Medicaid Services (CMS) should not extend reimbursement indications for carotid artery angioplasty/stenting

Anne L. Abbott, Mark A Adelman, Andrei V Alexandrov, Henry J M Barnett, Jonathan Beard, Peter Bell, Martin Bj̈orck, David Blacker, Clifford J Buckley, Richard P Cambria, Anthony J Comerota, E. Sander Connolly, Alun H. Davies, Hans-Henning Eckstein, Rishad Faruqi, Gustav Fraedrich, Peter Gloviczki, Graeme John Hankey, Robert E Harbaugh, Eitan Heldenberg & 21 others Steven J. Kittner, Timothy John Kleinig, Dimitri P Mikhailidis, Wesley S. Moore, Rebecca Naylor, Andrew Nicolaides, Kosmas Ioannis Paraskevas, David M Pelz, James W Prichard, Grant Purdie, Jean-Baptiste Ricco, Thomas Riles, Peter Malcolm W Rothwell, Peter Sandercock, Henrik Sillesen, J David Spence,, Francesco Spinelli, Aron Tan, Ankur Thapar, Frank J Veith, Wei Zhou

Research output: Contribution to journalReview ArticleOtherpeer-review

2 Citations (Scopus)

Abstract

In recent years, many important discoveries have been made to challenge current policy, guidelines, and practice regarding how best to prevent stroke associated with atherosclerotic stenosis of the origin of the internal carotid artery. TheUnited States Center forMedicare andMedicaid Services (CMS), for instance, is calling for expert advice as to whether its current policies should be modified. Using a thorough review of literature, 41 leading academic stroke-prevention clinicians from the United States and other countries, have united to advise CMS not to extend current reimbursement indications for carotid angioplasty/stenting (CAS) to patients with asymptomatic carotid stenosis or to patients with symptomatic carotid stenosis considered to be at "low or standard risk from carotid endarterectomy (CEA)." It was concluded that such expansion of reimbursement indications would have disastrous health and economic consequences for the United States and any other country that may follow such inappropriate action. This was an international effort because the experts to best advise CMS are relatively few and scattered around the world. In addition, US health policy, practice, and research have tended to have strong influences on other countries.

Original languageEnglish
Pages (from-to)200-207
Number of pages8
JournalBrain and Behavior
Volume2
Issue number2
DOIs
Publication statusPublished - Mar 2012
Externally publishedYes

Keywords

  • Carotid angioplasty
  • Carotid endarterectomy
  • Carotid stenting
  • Carotid surgery
  • Health economics
  • Public health
  • Vascular disease medical intervention

Cite this

Abbott, Anne L. ; Adelman, Mark A ; Alexandrov, Andrei V ; Barnett, Henry J M ; Beard, Jonathan ; Bell, Peter ; Bj̈orck, Martin ; Blacker, David ; Buckley, Clifford J ; Cambria, Richard P ; Comerota, Anthony J ; Sander Connolly, E. ; Davies, Alun H. ; Eckstein, Hans-Henning ; Faruqi, Rishad ; Fraedrich, Gustav ; Gloviczki, Peter ; Hankey, Graeme John ; Harbaugh, Robert E ; Heldenberg, Eitan ; Kittner, Steven J. ; Kleinig, Timothy John ; Mikhailidis, Dimitri P ; Moore, Wesley S. ; Naylor, Rebecca ; Nicolaides, Andrew ; Paraskevas, Kosmas Ioannis ; Pelz, David M ; Prichard, James W ; Purdie, Grant ; Ricco, Jean-Baptiste ; Riles, Thomas ; Rothwell, Peter Malcolm W ; Sandercock, Peter ; Sillesen, Henrik ; Spence, J David ; Spinelli, Francesco ; Tan, Aron ; Thapar, Ankur ; Veith, Frank J ; Zhou, Wei. / Why the United States Center for Medicare and Medicaid Services (CMS) should not extend reimbursement indications for carotid artery angioplasty/stenting. In: Brain and Behavior. 2012 ; Vol. 2, No. 2. pp. 200-207.
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abstract = "In recent years, many important discoveries have been made to challenge current policy, guidelines, and practice regarding how best to prevent stroke associated with atherosclerotic stenosis of the origin of the internal carotid artery. TheUnited States Center forMedicare andMedicaid Services (CMS), for instance, is calling for expert advice as to whether its current policies should be modified. Using a thorough review of literature, 41 leading academic stroke-prevention clinicians from the United States and other countries, have united to advise CMS not to extend current reimbursement indications for carotid angioplasty/stenting (CAS) to patients with asymptomatic carotid stenosis or to patients with symptomatic carotid stenosis considered to be at {"}low or standard risk from carotid endarterectomy (CEA).{"} It was concluded that such expansion of reimbursement indications would have disastrous health and economic consequences for the United States and any other country that may follow such inappropriate action. This was an international effort because the experts to best advise CMS are relatively few and scattered around the world. In addition, US health policy, practice, and research have tended to have strong influences on other countries.",
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author = "Abbott, {Anne L.} and Adelman, {Mark A} and Alexandrov, {Andrei V} and Barnett, {Henry J M} and Jonathan Beard and Peter Bell and Martin Bj̈orck and David Blacker and Buckley, {Clifford J} and Cambria, {Richard P} and Comerota, {Anthony J} and {Sander Connolly}, E. and Davies, {Alun H.} and Hans-Henning Eckstein and Rishad Faruqi and Gustav Fraedrich and Peter Gloviczki and Hankey, {Graeme John} and Harbaugh, {Robert E} and Eitan Heldenberg and Kittner, {Steven J.} and Kleinig, {Timothy John} and Mikhailidis, {Dimitri P} and Moore, {Wesley S.} and Rebecca Naylor and Andrew Nicolaides and Paraskevas, {Kosmas Ioannis} and Pelz, {David M} and Prichard, {James W} and Grant Purdie and Jean-Baptiste Ricco and Thomas Riles and Rothwell, {Peter Malcolm W} and Peter Sandercock and Henrik Sillesen and Spence,, {J David} and Francesco Spinelli and Aron Tan and Ankur Thapar and Veith, {Frank J} and Wei Zhou",
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Abbott, AL, Adelman, MA, Alexandrov, AV, Barnett, HJM, Beard, J, Bell, P, Bj̈orck, M, Blacker, D, Buckley, CJ, Cambria, RP, Comerota, AJ, Sander Connolly, E, Davies, AH, Eckstein, H-H, Faruqi, R, Fraedrich, G, Gloviczki, P, Hankey, GJ, Harbaugh, RE, Heldenberg, E, Kittner, SJ, Kleinig, TJ, Mikhailidis, DP, Moore, WS, Naylor, R, Nicolaides, A, Paraskevas, KI, Pelz, DM, Prichard, JW, Purdie, G, Ricco, J-B, Riles, T, Rothwell, PMW, Sandercock, P, Sillesen, H, Spence, JD, Spinelli, F, Tan, A, Thapar, A, Veith, FJ & Zhou, W 2012, 'Why the United States Center for Medicare and Medicaid Services (CMS) should not extend reimbursement indications for carotid artery angioplasty/stenting', Brain and Behavior, vol. 2, no. 2, pp. 200-207. https://doi.org/10.1002/brb3.32

Why the United States Center for Medicare and Medicaid Services (CMS) should not extend reimbursement indications for carotid artery angioplasty/stenting. / Abbott, Anne L.; Adelman, Mark A; Alexandrov, Andrei V; Barnett, Henry J M; Beard, Jonathan; Bell, Peter; Bj̈orck, Martin; Blacker, David; Buckley, Clifford J; Cambria, Richard P; Comerota, Anthony J; Sander Connolly, E.; Davies, Alun H.; Eckstein, Hans-Henning; Faruqi, Rishad; Fraedrich, Gustav; Gloviczki, Peter; Hankey, Graeme John; Harbaugh, Robert E; Heldenberg, Eitan; Kittner, Steven J.; Kleinig, Timothy John; Mikhailidis, Dimitri P; Moore, Wesley S.; Naylor, Rebecca; Nicolaides, Andrew; Paraskevas, Kosmas Ioannis; Pelz, David M; Prichard, James W; Purdie, Grant; Ricco, Jean-Baptiste; Riles, Thomas; Rothwell, Peter Malcolm W; Sandercock, Peter; Sillesen, Henrik; Spence, J David; Spinelli, Francesco; Tan, Aron; Thapar, Ankur; Veith, Frank J; Zhou, Wei.

In: Brain and Behavior, Vol. 2, No. 2, 03.2012, p. 200-207.

Research output: Contribution to journalReview ArticleOtherpeer-review

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T1 - Why the United States Center for Medicare and Medicaid Services (CMS) should not extend reimbursement indications for carotid artery angioplasty/stenting

AU - Abbott, Anne L.

AU - Adelman, Mark A

AU - Alexandrov, Andrei V

AU - Barnett, Henry J M

AU - Beard, Jonathan

AU - Bell, Peter

AU - Bj̈orck, Martin

AU - Blacker, David

AU - Buckley, Clifford J

AU - Cambria, Richard P

AU - Comerota, Anthony J

AU - Sander Connolly, E.

AU - Davies, Alun H.

AU - Eckstein, Hans-Henning

AU - Faruqi, Rishad

AU - Fraedrich, Gustav

AU - Gloviczki, Peter

AU - Hankey, Graeme John

AU - Harbaugh, Robert E

AU - Heldenberg, Eitan

AU - Kittner, Steven J.

AU - Kleinig, Timothy John

AU - Mikhailidis, Dimitri P

AU - Moore, Wesley S.

AU - Naylor, Rebecca

AU - Nicolaides, Andrew

AU - Paraskevas, Kosmas Ioannis

AU - Pelz, David M

AU - Prichard, James W

AU - Purdie, Grant

AU - Ricco, Jean-Baptiste

AU - Riles, Thomas

AU - Rothwell, Peter Malcolm W

AU - Sandercock, Peter

AU - Sillesen, Henrik

AU - Spence,, J David

AU - Spinelli, Francesco

AU - Tan, Aron

AU - Thapar, Ankur

AU - Veith, Frank J

AU - Zhou, Wei

PY - 2012/3

Y1 - 2012/3

N2 - In recent years, many important discoveries have been made to challenge current policy, guidelines, and practice regarding how best to prevent stroke associated with atherosclerotic stenosis of the origin of the internal carotid artery. TheUnited States Center forMedicare andMedicaid Services (CMS), for instance, is calling for expert advice as to whether its current policies should be modified. Using a thorough review of literature, 41 leading academic stroke-prevention clinicians from the United States and other countries, have united to advise CMS not to extend current reimbursement indications for carotid angioplasty/stenting (CAS) to patients with asymptomatic carotid stenosis or to patients with symptomatic carotid stenosis considered to be at "low or standard risk from carotid endarterectomy (CEA)." It was concluded that such expansion of reimbursement indications would have disastrous health and economic consequences for the United States and any other country that may follow such inappropriate action. This was an international effort because the experts to best advise CMS are relatively few and scattered around the world. In addition, US health policy, practice, and research have tended to have strong influences on other countries.

AB - In recent years, many important discoveries have been made to challenge current policy, guidelines, and practice regarding how best to prevent stroke associated with atherosclerotic stenosis of the origin of the internal carotid artery. TheUnited States Center forMedicare andMedicaid Services (CMS), for instance, is calling for expert advice as to whether its current policies should be modified. Using a thorough review of literature, 41 leading academic stroke-prevention clinicians from the United States and other countries, have united to advise CMS not to extend current reimbursement indications for carotid angioplasty/stenting (CAS) to patients with asymptomatic carotid stenosis or to patients with symptomatic carotid stenosis considered to be at "low or standard risk from carotid endarterectomy (CEA)." It was concluded that such expansion of reimbursement indications would have disastrous health and economic consequences for the United States and any other country that may follow such inappropriate action. This was an international effort because the experts to best advise CMS are relatively few and scattered around the world. In addition, US health policy, practice, and research have tended to have strong influences on other countries.

KW - Carotid angioplasty

KW - Carotid endarterectomy

KW - Carotid stenting

KW - Carotid surgery

KW - Health economics

KW - Public health

KW - Vascular disease medical intervention

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