Need for Heart Tests before Surgery

I don’t know about you, but if I am not feeling well and the doctor tells me I might need to have heart surgery of some sort, I am sure that I want any tests that are appropriate to be done before we get to the actual surgery part.  Unfortunately, if you are on Medicare, less than 44% of Medicare recipients are having those tests done because the doctors are not ordering them.

When a person is going to have angioplasty or have a stent implanted to open the arteries, there are risks involved.  The statistics show that 56% of individuals on Medicare who are going to have these procedures done are not getting heart stress tests and other valuable tests beforehand.  More than half of patients with stable heart disease are not getting exercise tests before doctors clear their coronary artery. These tests could determine the risks that patients face, and according to some doctors, these tests are essential and will not perform these procedures or surgeries without performing the tests first.

The stress test is so important because it determines how well a heart handles work, and that determines whether the patient even needs the angioplasty or not.  The joint guidelines from three United States heart groups say that it is necessary to perform the stress test to determine how badly the arteries are clogged and if there is a severe blockage to the flow of blood to the heart. 

It costs Medicare $15,000 for each angioplasty.  This has accounted for 10% in the Medicare expenses since 1990.  It has been suggested that Medicare reward doctors for practicing better medicine and having the stress tests done in advance.  Part of the reason for this is that in many cases the stress tests reveal that surgery is not necessary and that medication and other treatment which is less invasive and much less expensive will have the same results.

In fact, studies have shown that angioplasty without the proper tests in advance has contributed to $10,000 extra expense for those patients who did not have the tests, plus the death rate was higher for those who had angioplasty without the tests.  Those who had the tests had a 6% lower death rate and fared better overall, often without the angioplasty.

If you are in a situation where your doctor is considering angioplasty or other heart procedures, make sure to discuss having a stress test in advance.  If the doctor is non responsive, get a second opinion by a good cardiologist.  This is your heart and your life.  Especially with Medicare coverage, you should try to get the treatment that you actually need.