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Three health plans announce coverage for HeartFlow FFRct Analysis

por Lauren Dubinsky, Senior Reporter | September 05, 2017
Cardiology CT Insurance X-Ray
80 million Americans
now have access
Three health plans recently decided to provide coverage for the HeartFlow FFRct Analysis technology.

Anthem Blue Cross Blue Shield, Blue Shield of California, and Blue Cross and Blue Shield of Alabama provide health insurance for 44 million patients. After evaluating the technology’s technical performance, diagnostic accuracy, clinical utility and clinical benefits, they determined it’s medically necessary for members with stable chest pain after a coronary CT angiogram is performed.

Coronary artery disease accounts for about one in every five deaths in developed countries, making it the most common cause of mortality in those regions, according to a study published in Mayo Clinic Proceedings. The HeartFlow Analysis evaluates the extent of CAD as well as the impact it has on blood flow to the heart.
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Dr. John H. Stevens, president and CEO of HeartFlow, stated that an increasing number of national and regional commercial payors are providing coverage for the technology. That’s largely due to the evidence that it reduces the need for noninvasive and invasive tests and procedures, and lowers health care costs.

“With the growing number of health plans covering our technology, even more patients with suspected CAD will benefit by receiving a definitive personalized treatment plan based on the HeartFlow Analysis,” he said in a statement.

The other commercial payors include Aetna, which covers over 23 million lives, and additional Blue Cross Blue Shield companies that collectively have almost 5.5 million members. Nearly 80 million Americans now have access to HeartFlow Analysis.

The company that conducts health care technology evaluations for the Blue Cross Blue Shield Association is called Evidence Street. In June, it issued a review that determined HeartFlow Analysis provides a “meaningful improvement in net health outcome” in patients with stable chest pain.

The National Institute for Health and Care Excellence of the U.K.’s National Health Service, which covers 59 million lives, also issued guidance that recommended HeartFlow Analysis for determining the cause of stable chest pain.

The American College of Cardiology and the American Heart Association recently released Appropriate Use Criteria for patients with stable ischemic heart disease undergoing coronary revascularization. It included the use of HeartFlow Analysis for gauging the appropriateness of revascularization in many clinical scenarios.

In other news, Philips and HeartFlow Inc. announced a partnership on Monday to promote the combined use of HeartFlow Analysis and Philips’ advanced catheters. The companies have also entered a collaboration agreement to develop a cath lab X-ray image-derived fraction flow reserve or instant wave-free ratio solution.

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