Dr. Daphne Ferdinand from the Healthy Heart Community Prevention Project, at least week’s Atlantic Health Equity Summit.

Cardiology Practices

Cardiovascular Associates Bolsters VBC Capabilities with NovoCardia Acquisition

Private equity-backed and value-based care-focused cardiology group acquisitions have become an almost weekly occurrence in 2023, but Cardiovascular Associates of America’s (CVAUSA) acquisition of NovoCardia introduced a new telehealth-led angle to this trend.

Novocardia launched in 2020 with a vision of becoming a leading value-based care cardiology practice platform, and had since amassed $53.7M in funding and acquired two practices. In addition to helping its practices transition to VBC, Novocardia built a name for itself through innovative “telehealth-first” programs to support chronic patients and to give its practices a streamlined alternative to using a fragmented combination of solutions.

• Now Novocardia becomes “the Value-Based Care Division of Cardiovascular Associates of America,” responsible for developing new cardiovascular disease management programs (likely “telehealth-first”) and new value/risk-based reimbursement frameworks.

CVUSA and its private equity backers have been on an acquisition spree since forming in 2021, including seven acquisitions in 2022 and five so far in 2023 (including Novocardia), giving it 11 practices with over 100 locations in eight states, and more than 200 physicians serving 400k patients. 

• CVUSA has more acquisitions lined up, with plans to increase its physician workforce to over 450 by the end of 2023 (including >300 in Florida), and it appears that CVUSA will use Novocardia’s VBC enablement value proposition to drive much of that practice expansion.

The Takeaway

Cardiology practices were late to the private equity consolidation party compared to other specialties (e.g. radiology, dermatology, gastroenterology), but that’s changing fast as multiple PE-backed cardiology practice management organizations make their way across America with VBC-focused strategies. 

Although many of these PE-backed cardiology MSOs promise similar benefits to their cardiology group acquirees (an exit, “autonomy,” infrastructure, ability to scale, funding for ASCs), it appears that CVUSA just added a unique differentiator: a telehealth-first platform that can actually drive lower care costs.

Overcoming Cardiovascular Data Challenges

Aggregating multisource cardiology data is a worthy mission, but it’s often thwarted by confusion and complexity. This Change Healthcare article with Dr. Jennifer Hall, chief of data science at the American Heart Association, outlines best practices to help you overcome your cardiology data challenges and start leveraging deeper insights.

The Holy Grail of Heart Attack Prevention

See how CCTA AI can transform preventive heart care far beyond CAC scoring, in this upcoming Cleerly webinar featuring world-renowned prevention expert Dr. Arthur Agatston (author of the South Beach Diet, creator of the Agatston score), Cleerly founder Dr. James Min, and CMO Dr. James P Earls. Here’s where you can register today in order to join live on May 12th.

How to Optimize Echocardiography

How can AI be mobilized to automate the fight against heart disease? Us2.ai President Yoran Hummel, PhD, discusses how echocardiography can be optimized in an interview on The Medical AI Podcast

The Wire

• Public Health Crisis of Inequitable Proportion: If you weren’t able to make it to The Atlantic’s Health Equity Summit last week, its panel on the LDL-C public health crisis is worth checking out (fast-forward to 3:12). The Family Heart Foundation-hosted panel featured a broad range of perspectives on the “inequitable” barriers to properly detecting and managing high LDL-C in America, and it gave patients and providers plenty to think about.

• ANTWOORD Study Validates Antwerp Score: Results from the ANTWOORD study highlighted the Antwerp score’s effectiveness predicting HF patients’ response to AF ablation. In the 605-patient multicenter study, 70% showed significant LVEF improvement after ablation. The Antwerp score accurately predicted which patients would achieve LVEF improvements (AUC: 0.86), assisting clinicians in determining which patients may benefit from early referral for catheter ablation, alternative strategies, or further diagnostic tests.

• Us2.ai and Ascend’s Echo AI Alliance: In a deal to spur AI-assisted echocardiography reporting, Ascend Cardiovascular has partnered with Us2.ai to integrate the company’s AI algorithms with its InView zero-footprint software for cardiovascular viewing and reporting. Us2.ai’s solution analyzes 2D and Doppler echo images and can automate measurements and pre-populate structured report templates.

• Heart Rhythm Risk Skyrockets with Severe COVID: Findings presented at EHRA 2023 suggest that severe COVID patients (who required mechanical ventilation) have significantly higher risks for arrhythmias compared to those with mild infection within six months. The study compared 3k patients with severe COVID to 28.5 mild cases, finding that severe COVID patients had far greater risks of ventricular tachycardia (16-fold), atrial fibrillation (13-fold), other tachyarrhythmias (14-fold), and bradycardia/pacemaker implantation (9-fold).

• Teladoc Moves Into Weight Mgmt: Teladoc is the latest virtual care provider to throw its hat into the obesity ring after expanding its Provider-Based Care to weight management and prediabetes. The new cardiometabolic programs combine with Teladoc’s previously launched hypertension and diabetes services, offering a similar mix of physician-led treatment, day-to-day coaching, and of course GLP-1s and SGLT2s.

• Redo-TAVR Feasible for Most Patients with Evolut Valves: A Euro Intervention study showed that TAVR in existing transcatheter valves (redo-TAVR) is feasible for most patients with self-expanding Evolut valves – as long as the right technique is used. Analyzing 204 patients who underwent redo-TAVR, the study found the lowest risk of coronary flow compromise (20%) at Evolut node 4 and the highest risk (75%) at Evolut node 6. The study confirms that redo-TAVR is viable in 80% of cases, but women and high-BMI patients appear to face greater risks.

• Ultromics’ Amyloidosis Breakthrough Designation: The FDA granted Breakthrough Device Designation to Ultromics’ EchoGo Amyloidosis AI solution, which analyzes echocardiograms to identify patients with cardiac amyloidosis. Ultromics highlighted the solution’s potential to allow far earlier amyloidosis detection, citing the well-known challenges diagnosing the disease before it reaches advanced stages, and noting that many amyloidosis patients undergo echo exams well before being diagnosed. EchoGo Amyloidosis is a module within Ultromics’ EchoGo Platform, and is currently a candidate for FDA submission.

• Overworked Residents Affect Patient Safety: A study in BMJ Medicine links longer resident work hours to adverse safety events. The study of 4,826 senior residents found that those who worked over 48 hours a week had higher rates of medical errors and adverse events. For those working 60-70 hours a week, the risk was double (OR: 2.36) for medical errors and triple (OR: 2.93) for preventable adverse events.

• Kaiser to Acquire Geisinger: A blockbuster acquisition is underway between Kaiser Permanente and PA-based Geisinger, marking a fresh chapter in KP’s expansion as it launches a new company, Risant Health, to support nonprofit community health systems. Risant Health will operate independently – Geisinger will be folded in and keep its name – while it looks to extend KP’s value-based care model more broadly throughout the country. KP is planning to invest $5B in Risant over the next five years (revenue was $95B in 2022), and expects to add up to six health systems to Risant in that time.

• AF Comorbidity Management: The EHRA-PATHS consortium announced that it is developing a software tool to ensure that elderly AF patients’ comorbidities are properly detected and managed. The tool will provide a standardized approach for identifying and managing 22 comorbidities relevant to AF patients, noting that AF patients have an average of five co-existing conditions, and three-quarters of them take at least five medications. The forthcoming software will be evaluated in a 1,300-patient clinical study, leading to a 1,080-patient RCT across 65 hospitals in 14 European countries.

• Abbott’s Life Support Clearances: Abbott announced two new life support system FDA clearances, expanding its CentriMag Blood Pump for longer-term use with critically ill ECMO patients (previously cleared for 6hrs), and clearing its CentriMag Pre-connected Pack (combines a blood pump and oxygenator) for use with urgent critical care patients up to six hours.

The First Step to Coronary Artery Disease Diagnosis

HeartFlow’s new RoadMap Analysis solution allows CT readers to accurately, efficiently, and consistently identify stenoses in the coronary arteries. See how RoadMap Analysis’ visual and quantitative insights into the narrowing of all major coronary arteries helps readers evaluate coronary CT angiograms before determining the need for an FFRCT.

ECG Data You Can Trust

Noise and artifacts can make automated ECG analysis less reliable than what’s required for the exacting standards of cardiac safety trials. Monebo’s Kinetic Intervals ECG Algorithm provides precise interval measurements between any two points on the ECG waveform, allowing clinicians to utilize data they can trust.

Relieving The Burden of Post-Processing

With the advent of advanced imaging technologies like CCTA come added burdens to technologists and diagnostic imaging centers. See how PIA can relieve the burden of post-processing, saving you time while helping your bottom line.