An Analysis of Inpatient and Outpatient Radiofrequency Cardiac Ablation: Quality Outcomes and Reimbursement

Abstract

Background Radiofrequency ablation for the treatment of atrial fibrillation currently stands as the first line therapy for the condition. The therapy is a costly means of managing the disease, with both inpatient and outpatient coding options in the hospital. A major determinant ablation readiness and status of the patient still remains in the physician’s discretion, and outcomes may not be aligned with the status of patient at the time of the ablation. Shifting these patients to an outpatient ablation status may create significant savings if the outcomes are equivalent. Results A total of 87 new onset AF patients were sampled and monitored post ablation. Recurrence rates for markedly higher for those in the inpatient setting (14.2%) over the course of a year versus the inpatient cohort (8.2%). Similar findings were observed in readmission rates, whereas the inpatient cohort reflected a higher incident of readmission post ablation within the course of a year versus that of the inpatient cohort (14.2% vs. 2.6%). Conclusion Although there is a need for an inpatient billing paradigm, stabilizing a new onset AF patient and shifting them to the outpatient setting can and create significant savings to Medicare while still maintaining the same quality of care