Health Care Today
description
Transcript of Health Care Today
Health Care Today
Weaknesses of Current System
• Problematic hand-offs• Poor adherence• Unsystematic chronic disease
management• Significant variation and inefficiency• Persistent disparities• Poor population-based progress
Source: Congressional Budget Office
Physician Reimbursement Losing Ground to Inflation, Costs
“We in America do not have government by the majority. We have government by the majority who participate”
Thomas Jefferson, 1787
To stop arbitrary payment cuts and proactively pursue a new standard for health care reform that is centered on patient value and access to quality care.
The ACC’s Goal:
ACC Action Plans for Reform
1. Test payment models that reward quality; stop arbitrary payment cuts
2. Reduce disparities and geographic variations in care
3. Reduce CV hospital re-admission rates (H2H Initiative)
4. Facilitate appropriate imaging (AUC/decision support at point of care)
5. Seek opportunities to promote tort reform
• Share best practices• Learn and teach• Deploy QI initiatives based on practice needs• Implement Appropriate Use Criteria• Use interoperable electronic systems to:
– exchange data – deliver decision support – reduce errors
Quality First in Action
We have the tools now!
• ACC/AHA Clinical Guidelines• Performance Measures• Appropriate Use Criteria
– SPECT MPI (Updated in 2009)– CCT and CMR– Stress Echocardiography– TTE/TEE– Coronary Revascularization
Number of sites and patient records
1998….. 2004 2005 2006 2007 2008 beyond
CathPCICathPCIRegistryRegistry
1132, 8.6M1132, 8.6M
ICDICDRegistryRegistry
1445, >120K1445, >120K
CARECARERegistryRegistry166, >9K166, >9K
ACTION-GWTGACTION-GWTGRegistryRegistry
445, >120K445, >120K
IC3-OfficeIC3-Office600, >15K600, >15K
ImagingRegistry
HFRegistry
PADRegistry
EPRegistry
IMPACTRegistry
ICD LongICD Long
NCDR:
Challenges to Reform
• Crowded arena• Short timeline and no “real” meat on
reform bills• Tendency to focus solely on cutting
costs• CMS proposal to cut Medicare
payments for CV services by as much as 40%
Physician Payment: Fixing the SGR
•Congress intervened since 2003 to stop SGR cuts; action necessary again to stop latest cuts and replace flawed formula
•Bipartisan consensus that formula needs to be replaced
•Long-term reform held up by increasing cost and lack of consensus
• Proposed Medicare 2010 Physician Fee Schedule– Overall 11% decrease in Medicare payments for
cardiology services. – Reimbursement for almost all cardiovascular
services would see cuts ranging from 10% - 40%.– Practice expense survey data used by CMS to
determine cuts were not reviewed or validated.– CMS used responses from only 55 practices
Physician Payment
Physician Payment: Message to Congress
• Stop proposed CMS cuts!
• Replace flawed formula with more sustainable system that reflects increases in practice costs and accounts for appropriate growth in services
• Test models that seek to reduce variations in spending and ensure patients receive evidence-based care
Now is the Time to Fight!
Ways to Get Involved With Congress
• Grassroots: www.acc.org/can(Includes ACC’s toll-free grassroots hotline, patient materials, sample letters, and more)
• ACC PAC: www.accpacweb.org• ACC 2009 Legislative Conference:
Sept. 13-15, Washington, DC
Member Resources
• Patient Materials: www.acc.org/Chapters
• Health IT Resources: www.acc.org/healthit
• Lewin Report Online Forum lewinreport.acc.org
American College of Cardiologyhttp://qualityfirst.acc.org