Heart disease is the leading cause of death—every 37 seconds someone in the U.S. dies from cardiovascular disease. Despite the incidence and seriousness of this disease, diagnostic strategies have not changed much over the past 30 years. Most patients with suspected disease typically undergo stress testing, including treadmill stress tests, an ultrasound of the heart or a nuclear imaging study. Multiple clinical trials have demonstrated how inaccurate and inefficient these tests are, failing to identify critical disease on some, leading to either more tests or sending patients who don’t have significant disease for invasive evaluation in the cardiac catheterization lab (cath lab). A recent study found that invasive treatment, guided by stress testing, did not improve rates of death or heart attack compared to medical therapy alone.
New, non-invasive treatments are here
Enter HeartFlow Analysis, a non-invasive pathway that identifies a patient’s disease burden and gives physicians all the information they need to make an informed treatment decision in one visit.
Typically a patient would come in for a CT scan of the coronary arteries—the simple imaging procedure is performed in less than an hour, physicians then use these detailed images to identify the severity of blockages. If additional information was needed, as is the case for approximately 25 percent of patients, clinicians would have to send patients for additional, costly testing. Using the images from a CT scan and creating a personalized, digital 3D model of a patient’s coronary arteries, HeartFlow Analysis allows physicians to evaluate the impact of blockages, diagnose and identify the appropriate treatment all in the same visit.
Reducing unnecessary procedures and costs
HeartFlow Analysis is proven to reduce unnecessary procedures and reduce costs for the healthcare system compared to other non-invasive tests. In fact, the PLATFORM trial demonstrated that unnecessary invasive procedures dropped from 73 percent in the standard care group to just 12 percent in patients whose care was guided by a CT of the heart and the HeartFlow Analysis.
A real-world evaluation performed by a test-and-learn platform associated with Highmark Blue Cross Blue Shield demonstrated even greater effectiveness. Physicians at the Allegheny Health Network in Pittsburgh, using the HeartFlow Analysis, were able to avoid 80 percent of planned invasive procedures, leading to average cost savings of $1,352 per patient in the three months after HeartFlow Analysis, a 66 percent decrease.
By reducing the rate of unnecessary and more costly invasive procedures, the CT and HeartFlow Analysis pathway would offer annual savings of $2.7 billion to Medicare. In comparison, the Medicare Payment Advisory Commission (MedPAC) has identified stress testing as a low-value service that costs Medicare more than $2.7 billion annually. Invasive coronary angiographies add an additional $4.3 billion for a total spend on low-value services of $7 billion annually. Despite the overwhelming clinical and economic data, Medicare’s current rate setting methods have reduced payment for both CT and the HeartFlow Analysis, while increasing payment for stress testing and invasive angiograms.
New tools for diagnosing and treating patients with suspected coronary disease are here and are effective, and while many commercial insurers see the clinical and economic advantages of the new pathway and are creating programs to support the adoption of new technology, we hope to see an increase in adoption of value-based payments for cardiovascular services in 2020.
HeartFlow, Inc. is a digital health company uniquely positioned at the intersection of advanced artificial intelligence and healthcare to transform how heart disease is diagnosed and treated. Our non-invasive HeartFlow FFRct Analysis leverages deep learning to create a personalized 3D model of the heart. By using this model, clinicians can better evaluate the impact a blockage has on blood flow and determine the best treatment for patients. Our technology is reflective of our Silicon Valley roots and incorporates decades of scientific evidence with the latest advances in artificial intelligence. The HeartFlow FFRct Analysis is commercially available in the United States, Canada, Europe and Japan. The HeartFlow Planner is commercially available in the United States only. For more information, visit www.heartflow.com.