title: Expansion of heart failure device therapy into a rural indigent population in Louisiana: potential economic and health policy implications.
abstract: BACKGROUND
  Research regarding the use of implantable devices in patients with congestive heart failure (CHF) has shown mortality benefits. The Center for Medicare and Medicaid Services (CMS) approved new criteria for expanding coverage for such therapies. The purpose of this study was to determine the percentages of CHF patients in a rural, indigent heart failure population that would be eligible for implantable defibrillators (ICD) and cardiac resynchronization therapy (CRT) based on the new CMS criteria.
  
  
  RESULTS
  The new CMS guidelines were applied to information compiled in a database for 451 CHF disease management patients, at Leonard J. Chabert Medical Center. Results show that, annually, 32% of the newly identified CHF patient population would be eligible for ICD therapy and 7.3% would be eligible for CRT therapy.
  
  
  CONCLUSIONS
  Providers of health care to the indigent may lack sufficient resources for the devices and the infrastructure for device implantation and follow-up.
authors.affiliation: Leonard J. Chabert Medical Center, Houma, Louisiana 70363, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Hebert
authors.forename: James
authors.initials: J
authors.lastname: McKinnie
authors.forename: Ron
authors.initials: R
authors.lastname: Horswell
authors.forename: Lee
authors.initials: L
authors.lastname: Arcement
authors.forename: Lynne
authors.initials: L
authors.lastname: Stevenson
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000191:economics; D017147:Defibrillators, Implantable / Q000191:economics; D004467:Economics; D004554:Electric Countershock / Q000191:economics / Q000295:instrumentation; D005260:Female; D017048:Health Care Costs; D006291:Health Policy; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008145:Louisiana; D008297:Male; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000191:economics; D011203:Poverty; D012424:Rural Population