Newman Medical News

Opening the Real Stenosis in Peripheral Artery Disease Detection

Peripheral artery disease (PAD) represents one of healthcare’s most significant diagnostic challenges—not because it’s difficult to detect, but because it’s so rarely tested for in the first place. Despite affecting an estimated 18 million Americans, PAD remains dramatically underdiagnosed, creating what healthcare professionals call a “stenosis” or bottleneck that prevents patients from receiving life-saving interventions.

For healthcare organizations and primary care practices, this diagnostic gap represents both a critical patient care issue and a substantial missed revenue opportunity. The solution? Implementing comprehensive PAD screening programs using proven diagnostic tools like the simpleABI system from Newman Medical.

Understanding the True Impact of Peripheral Artery Disease

More Than Just Leg Pain

Many healthcare providers still perceive PAD as a relatively benign condition characterized primarily by intermittent claudication—leg pain when walking. This outdated understanding couldn’t be further from the truth. Modern research has revealed that PAD is actually a manifestation of systemic atherosclerotic disease with devastating consequences.

Patients with PAD face significantly increased risks of:

• Mortality from cardiovascular events
• Limb amputations
• Stroke
• Myocardial infarction (MI)
• Severely diminished quality of life

The financial burden is equally staggering. Treatment for the initial PAD intervention and first-year follow-up actually costs more than treatment for cardiovascular disease—a fact that surprises many healthcare administrators.

The PAD Patient Universe: Larger Than You Think

Recent studies from the SAGE group indicate that approximately 18 million people in the United States had PAD in 2010, and that number continues to grow with our aging population. The highest-risk groups include:

• Adults over age 65: Approximately 20% of people over age 70 have PAD
• Adults over 50 with risk factors: Those with a history of smoking or diabetes have a 30-40% prevalence rate
• Patients with known atherosclerotic disease: Those with coronary, carotid, or renal arterial disease
• Symptomatic patients: Individuals experiencing leg symptoms with exertion, ischemic rest pain, or abnormal pulses

Among diagnosed PAD patients, approximately 30% require vascular intervention, and about 40-50% of those patients need treatment on both lower limbs.

The Diagnostic Stenosis: Why PAD Goes Undetected

The landmark PARTNERS study revealed a shocking statistic: 29% of at-risk populations have PAD, yet only a fraction receive diagnosis and treatment. Here’s the breakdown of this diagnostic failure:

• 11% detection rate when relying solely on classical claudication symptoms
• 16% overall current diagnosis rate even when including other symptoms
• Nearly 50% of PAD patients are completely asymptomatic and can only be identified through ABI (ankle-brachial index) testing
• Only 15% of patients with claudication are referred to vascular specialists

This massive gap between prevalence and diagnosis creates the “stenosis” that limits patient flow to appropriate treatment. The key to opening this bottleneck is straightforward: increase the number of at-risk patients undergoing PAD testing.

The Business Case for PAD Screening: Revenue Impact Analysis

Healthcare organizations that implement comprehensive PAD screening programs see dramatic improvements in both patient outcomes and revenue generation. Consider this comparison based on 1,000 at-risk patients:

Current Model (No Systematic Testing):

• 290 patients actually have PAD
• Only 32 cases are recognized
• Testing revenue: $3,650
• 10 vascular interventions performed
• Intervention revenue: $150,000

Enhanced Model (With Systematic Testing and Screening):

• 290 patients with PAD
• All 290 cases are recognized through screening
• Testing revenue: $33,060
• 87 vascular interventions performed
• Intervention revenue: $1,305,000

The difference is striking—an increase from $150,000 to over $1.3 million in intervention revenue from the same patient population. This doesn’t even account for the recurring hospitalizations and repeat revascularizations that many patients require within two years following initial procedures, as demonstrated by the REACH study.

Additional Benefits for ACOs and Medicare Advantage Plans

For Accountable Care Organizations (ACOs) and Medicare Advantage Plans (MAP), the benefits extend beyond procedure revenue. These organizations receive risk adjustment payments based on documented diagnoses. For vascular disease, the increased revenue from risk adjustment factors is approximately $3,000 per patient—generating $870,000 in additional revenue from properly documenting 290 PAD cases among 1,000 at-risk patients.

Making PAD Screening Accessible and Profitable

Historically, the high cost of vascular diagnostic equipment created a barrier to widespread PAD screening in primary care settings. Newman Medical has eliminated this obstacle with affordable, reimbursable diagnostic solutions.

The simpleABI Advantage

Newman Medical’s simpleABI systems represent a breakthrough in accessible PAD diagnostics. These computer-based systems:

• Can cost less than $3,000 (depending on system)—significantly less expensive than previous products
• Meet all current reimbursement criteria for proper billing
• Generate an average reimbursement of $114 per comprehensive test
• Provide accurate, objective ABI measurements for reliable PAD detection

This affordability makes it feasible for healthcare organizations to equip multiple primary care offices with screening capability, dramatically expanding the diagnostic net for at-risk patients.

Implementing a Successful PAD Screening Program

Forward-thinking healthcare organizations are recognizing the value proposition of providing primary care offices with PAD diagnostic systems. The typical implementation model includes:

1. Equipment provision: Healthcare systems provide simpleABI diagnostic equipment to affiliated primary care practices
2. Training and support: Comprehensive training ensures proper testing protocols and billing procedures
3. Referral agreements: Primary care offices agree to refer patients with abnormal results to the system’s vascular specialists
4. Revenue sharing: The increased intervention volume benefits the entire healthcare system

This approach creates a win-win-win scenario: patients receive earlier diagnosis and treatment, primary care practices add a reimbursable service line, and healthcare systems dramatically increase their vascular intervention volumes.

Beyond Revenue: The Patient Care Imperative

While the financial benefits of PAD screening are compelling, the patient care improvements are even more significant. Earlier PAD diagnosis enables:

• Prevention of limb amputations through timely intervention
• Reduced risk of cardiovascular events through appropriate medical management
• Improved quality of life by addressing symptoms before they become severe
• Lower overall healthcare costs by avoiding expensive emergency interventions
• Better long-term outcomes through coordinated vascular care

The cost of advanced PAD treatment—including potential amputation costs of up to $35,000—far exceeds the cost of early screening and intervention.

Taking Action: Transform Your PAD Diagnostic Approach

The evidence is clear: systematic PAD screening using tools like simpleABI from Newman Medical transforms both patient outcomes and healthcare economics. By breaking through the diagnostic stenosis that currently limits PAD detection, healthcare organizations can:

• Identify previously undiagnosed PAD in up to 90% of affected at-risk patients
• Generate substantial additional revenue from vascular interventions
• Improve quality metrics and patient satisfaction scores
• Reduce long-term healthcare costs through earlier intervention
• Enhance care coordination across the healthcare system

Newman Medical provides not just diagnostic equipment, but a complete solution including training, educational materials, and marketing support to help healthcare organizations implement successful PAD screening programs.

Conclusion: Open the Stenosis, Transform Your System

The stenosis limiting PAD diagnosis and treatment isn’t physiological—it’s systematic. With affordable, accurate diagnostic tools like Newman Medical’s simpleABI systems, healthcare organizations can finally screen the millions of at-risk Americans who deserve early detection and intervention.

The question isn’t whether your organization can afford to implement comprehensive PAD screening. The real question is: can you afford not to?

Related Resource

This article is based on the white paper “Opening The Real Stenosis” by Dennis Newman of Newman Medical.