Yakima Regional to keep monopoly on elective angioplasties

YAKIMA — Heart patients won't be choosing to have their clogged arteries opened at Yakima Valley Memorial Hospital anytime soon.

In a final rule adopted last week, the state Department of Health effectively extended Yakima Regional Medical and Cardiac Center's monopoly on doctor-advised angioplasties.

The decision followed nearly two years of debate since the Legislature directed the Department of Health to study the issue.

Rick Linneweh, Memorial's chief executive, said the hospital is "unsatisfied, disappointed and disturbed" by the decision, which also limits the ability of other hospitals in the state to offer elective angioplasties.

"We will find an avenue for challenging this. In the mind of the board, this is an injustice," Linneweh said. "This freezes us out of being able to offer what our patients want."

Linneweh declined to say exactly how the hospital will challenge the rule.

Leading opponents of expanding nonemergency angioplasty have been Regional's parent, Health Management Associates of Naples, Fla., Swedish Medical Center in Seattle and Providence Health System, which has heart centers in Olympia, Everett and Spokane.

Regional officials declined to comment. In the past, they have said that allowing Memorial to do the procedure would create an unnecessary and expensive duplication of medical services in Yakima County.

Memorial has offered cardiology services for years but is limited by state law to emergency procedures, diagnostic testing and rehabilitation because, unlike Regional, it doesn't have open-heart backup capabilities.

If something goes wrong during an emergency angioplasty at Memorial and open-heart surgery is required, the patient is taken to Regional.

Hospitals are reimbursed from $11,000 to $18,000 for each elective angioplasty, formally called adult elective percutaneous coronary intervention.

During the procedure, a thin tube called a catheter with a balloon on the end is inserted into an artery and threaded to the blockage. The cardiologist inflates the balloon, pushing the blockage against the artery walls and allowing blood to flow to the heart. A tiny metal scaffold called a stent may also be inserted to keep the wall open.

Linneweh said Memorial is already performing between 150 and 160 emergency angioplasties a year, a volume he said equals or exceeds that of Regional.

• Leah Beth Ward can be reached at 577-7626 or lward@yakimaherald.com