Payment by activity and financing of innovative hospital procedures: does the new payment system cover endovascular treatment for cerebral aneurysms?

Method We have calculated all hospital expenses related to treated intracerebral aneurysms for 2005. Catheters, micro-catheters, and guidewires as well as coils were included. We have compared these expenses to the payment by activity and fee per service collected for providing these services. Results: Payments received covered only a third of the expenses for the supplies used. Three types of expenses are not reimbursed: the guiding material, the coils used but not released, and the latest generation of coils not yet added to the national list of covered devices. These expenses are also not covered by the payment received for the hospital admission. Discussion: Endovascular management of intracranial aneurysms has become the treatment of choice over the recent years. This treatment is virtually only available in university hospitals. With the current mode of reimbursement, such treatment generates losses to the hospital. Conclusion: This example raises the question of financial support for innovative treatments and procedures.