While the number of hospitals providing invasive coronary services has increased, access to these procedures has not improved because hospitals offer new services in locations where similar cardiac programs already exist.

In a recent blog post on the American College of Cardiology’s ACC in Touch Blog, David May, MD, PhD, FACC, weighs in on a Health Affairs article that concluded, “Europe’s strong primary care systems are linked to better population health but also to higher health spending.” May takes aim at the metrics used to come to this conclusion and offers his insight about healthcare delivery in America and around the world.

Transcatheter aortic valve replacement (TAVR), which has rarely been described as a significant bargain economically, emerged as more expensive than previously reported in a cost-effectiveness analysis published July 9. A team from the PARTNER trial agreed with the researchers on one point: the need to define patient groups for whom TAVR provides good value.

Capitation appeared to lower the use of cardiac procedures but it didn’t rein in regional variation. The findings, published July 10 in JAMA, underscore the need to identify drivers behind variation, the authors wrote.

Two simple preoperative procedures significantly reduced the risk of site infections in cardiac and other surgeries. The protocol, which was reported in Antimicrobial Resistance and Infection Control, saved the health system more than $1 million.

ProPublica and NPR teamed up in an analysis of Medicare data to investigate prescribing habits for nebivolol (Bystolic), a treatment for hypertension. They reported that 17 of the top prescribers in 2010 accepted $283,450 in fees for promotional talks and more than $20,000 for meals from the drugmaker, Forest Laboratories. Most of the same names appeared again in results for 2011, the most recent year that data were available.

Most people agree reimbursement that rewards volume has fueled overuse and high costs for U.S. healthcare. But few agree on the best replacement. François de Brantes, executive director of the Health Care Incentives Improvement Institute, made a case for pay-for-performance incentives recently in the Wall Street Journal. Steffie Woolhandler, MD, MPH, of the City University of New York School of Public Health, shared why she thinks it is a bad idea.

A Medicare advisory panel recommended changes to Congress that included initiatives to reduce payment differences between hospital outpatient and physician office payment rates. One option targeted cardiac imaging services for a projected annual savings of $500 million.