Excerpt from Chapter One, "Sizing Up the Game: Current Industry Trends"
by: Jackie Johnson

Hearts are Hot!—which is very good news that can bring great opportunity for health care providers everywhere. As we consult with hospital leaders throughout the country in community, urban, and academic hospital settings, we are acutely aware of the critical importance of the cardiovascular service line to an organization’s bottom line and sometimes to its very future. This importance also translates to a strong impact on the health status of a community.

These are the facts: Nearly one out of every two people in the United States will contract cardiovascular disease in his or her lifetime. And, cardiovascular disease claimed nearly one million lives in 1999, and remains the number one cause of death in the U.S. today, totaling over 40% or one out of every 2.5 deaths in this country.[i] These statistics are startling, particularly since, in spite of all of our scientific innovation and clinical wherewithal, we have yet to come close to finding a cure for this dreadful disease.

So it should be of no surprise that cardiovascular services represent the most strategic service line for acute care hospitals in this country. To underscore this point, cardiovascular services can represent up to 40% of a hospital’s net revenue[ii]—and, this can convert to even more in profit with astute business management. On the other side of the coin, rising technology and construction costs in the face of tightened reimbursements present serious management challenges to capture the financial rewards.

Beyond the pure economics, as the population ages and the ‘baby boomers’ reach the over-45 threshold, the demand for diagnosis, treatment, and prevention in cardiovascular care is rapidly growing, and will continue to escalate in the years to come. This growth in the at-risk population, combined with tremendous advances in clinical research, has presented opportunities to detect and treat the disease earlier, to handle more complex conditions, and to eliminate age as a barrier to treatment.

The growth in population need, the rapid clinical advances surrounding cardiovascular diagnosis and treatment, and the search for new sources of revenue have generated dramatic increases in the ‘4 Ps’ of cardiovascular market development: Patients, Procedures, Physicians, and Programs. The following section will discuss how each of these segments impacts the market trend to expand and advance cardiovascular services.

Patients (who are People!) are presenting for cardiovascular services in growing numbers as 1) the demand for care increases with age; 2) today’s educated consumer seeks earlier diagnosis and treatment (and is often identified earlier as being at risk by a managed care or care management program); 3) newly proven preventive strategies emerge; 4) access expands to rural communities; 5) women are more recognized as being at risk for cardiovascular disease; and 6) clinical research findings continue to improve the treatment options. These are some of the industry statistics that fuel growing demand and utilization in cardiovascular services and underscore the need for astute strategic planning and operations management:

The population at risk for cardiovascular disease is increasing rapidly. Each population segment over the age of 45 years is increasing in size. By the year 2010, more than 26% of the population will be between the ages of 45 and 64.[iii] This aging of the population will increase the demand for and utilization of cardiac and related services over the next 20 years or until a cure is found.

The baby boomer population is a rapidly growing segment of the over-45 population. This population, perceived to be more health conscious and interested in lifestyle impacts, will likely demand more preventative and less invasive cardiovascular services. In the 2000 Census Report, the ‘baby boom’ cohort of ages 36 to 54 represented 28% of the total U.S. population.[iv] Industry experts are predicting spiraling increases in the utilization of cardiovascular services over the next decade as a response to these population trends.

People are living longer today and the average life span in the U.S. has expanded to 74.1 years for men and 79.5 years for women. This trend sets the stage for more cardiovascular disease detection and treatment, given the chronic nature of cardiac disease and the availability of more treatment options.[v]

The population of elderly females is growing significantly. The female population of 65 years and older grew over 10% between the years 1990 and 2000. Most of the increase occurred in the over-75 population,[vi] prompting a growing need for program development geared to this more elderly, frail, and resource-intensive population. Also, as awareness of the implications of cardiovascular disease in women heightens, so will the demand for more cardiovascular services that are targeted to this underserved population.

Over one million Americans will experience a new or recurrent acute myocardial infarction (AMI) or ‘heart attack’ each year. Of these victims, around 60% will experience first time events; and, nearly half of the individuals who experience AMI will die within a year of the event.[vii] Such statistics underscore the severity of the disease and the related human trauma, which strengthens the case for more access to cardiovascular services.

Nearly 4.8 million Americans are living with heart failure and about 550,000 new cases are identified each year. Among adults over age 65, heart failure is the number one reason for admission to a hospital.[viii] Further, 50% of persons diagnosed with congestive heart failure (CHF) will not survive five years; in fact, since 1979, CHF deaths increased 145%.[ix]
In short, these latest statistics reinforce that the need for cardiovascular services will greatly increase over the next decade. As a result, the need for astute program development and business management will be greater than ever before.

[end of excerpt]

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