Improving Patient Outcomes While Reducing Healthcare Cost  

Advanced Cholesterol Therapy is the Cornerstone

These data are from CMS (Center for Medicare and Medicaid Services) comparing the significant cost savings for Medicare among patients with diabetes ($11,921 versus $18,420) and among patients with coronary heart disease ($13,327 versus $22,117) under the care of Dr. R. deGoma compared to the national average for all cardiologists. 

For those with CHD, there is a 40% cost reduction, a saving of $8,790 per beneficiary. For those with diabetes, there is a 36% cost reduction, a saving of $6,499 per beneficiary.  

These cost savings are due to the high quality of care the our patients receive which results in much fewer cardiac hospitalizations, stents, heart bypass surgeries and other expensive procedures. What is not included in these data is the reduction in premature deaths and disabilities. Dr. deGoma has been doing this for his patients since 2001 and has published two performance data (89% treated to an LDLc <100 mg/dL; 51% treated to an LDLc <70 mg/dL.


Heart disease death rates have increased for the first time in decades and stroke death rates also have gone up, according to new federal statistics that show a drop in U.S. life expectancy.

The number of Americans dying of heart disease increased last year for the first time in more than a decade, delivering a wake-up call to the medical and scientific communities. After nearly 40 years of victories in the battle against heart disease — from the development of medications to control blood pressure and cholesterol to the public campaign against smoking — heart health experts are now facing a stark truth: Progress has stalled.

Heart disease is the No. 1 killer in America, responsible for about 1 in every 4 deaths. New data released by the National Center for Health Statistics shows it took more than 633,000 lives in 2015. 

The rise in heart disease deaths is a surprising change, since they had been declining rapidly since 1969. The last time there was an uptick was between 1992 and 1993. The latest data reinforces another troubling trend: the annual number of heart disease deaths hasn’t gone down since 2011.

After practicing traditional cardiology for 20 years, Dr. R. deGoma made a decision to find a way to create innovations to successfully incorporate optimal prevention as part of all cardiology visits.  He succeeded in preventing most heart attacks, strokes, heart failures, reducing the need for stents, heart bypass surgeries, hospitalizations, improving patient outcomes while reducing cost.

Applying preventive cardiology and clinical lipidology to create a strong barrier to prevent most high risk patents from suffering from heart attack, stroke and sudden death is the key to success. An innovative approach is needed.

Using PaKS approach and ACCEPT system, Dr. R. deGoma closed the treatment gap in his practice in 2006 and began “turning off the faucet instead of just mopping the floor”. He published two performance data - the first in 2006 with 85% of high and very high risk patients reaching LDLc less than 100 mg/dL. The second was May 2017 which was presented as an eposter in the annual scientific sessions of the National Lipid Association in Philadelphia shown above. 89% with LDLc less than 100 mg/dL and 51% with LDLc less than 70 mg/dL.

 It is time to turn off the faucet instead of just mopping the floor.

CDC Chief Dr. Tom Friedan: “How can the healthcare system save the most lives? We can save the most lives by preventing heart disease and stroke.

Most of the 525,000 Americans who will suffer their first heart attack this year are not aware they have a silent heart disease that is medically treatable and their heart attack could have been prevented. 

AHA Statistics Oct2017
2015 AHA MI Statistics-2

The slide highlights a serious national health problem that is begging to be solved. There is a real urgency to find a solution for several reasons: it touches the lives of nearly every American family; heart attacks are largely preventable and the cost to the nation is in the hundreds of billions every year. 

Previous attempts to reduce heart attacks failed:  1) Emergency stenting during a major heart attack is not a solution since shorter door-to-time time failed to show benefit - it did not reduce 30 day mortality. 2) Even intensive lifestyle intervention (Look AHEAD Trial) did not prevent heart attack. 3) The landmark COURAGE Trial showed that in stable patients with advanced multi-vessel CHD, the addition of stent therapy to optimal medical therapy did not prevent heart attack or cardiac death. Because these interventions are as effective as originally thought,  elevates the role of aggressive medical prevention to a more prominent position - there is a lot of science behind it, it is highly effective, alters the progressive course of atherosclerosis, saves lives and reduces healthcare cost. 

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