ACC Corner: “Quality First” in Healthcare Reform Debate

Health system reform is imminent. If you travel anywhere in the United States, you will find physician and patient satisfaction levels decreasing as a result of inconsistent quality, lack of coordinated care and medical liability concerns. Combine these factors with 47 million uninsured Americans, and you have a system primed for reform.

With 43 percent of Medicare dollars spent on heart disease—the nation’s No.1 killer—the American College of Cardiology (ACC) is taking an active role in reform efforts. We are working to engage patients, lawmakers, payers and the rest of the medical community in a discussion around a new standard of healthcare reform centered on increasing access to care and ensuring greater patient value.

Through its “Quality First” campaign, the ACC is encouraging healthcare providers to act on their individual and collective responsibility to “transform healthcare from the inside out.” Physicians, nurses and other care providers are on the front lines of care delivery and can best ferret out waste and unnecessary or inappropriate care and focus instead on continuous quality and outcomes improvement.

As such, the ACC is working to ensure that the following principles are a fundamental part of any healthcare reform effort:

  • A focus on patient value
  • Coordination across sources and sites of care
  • Payment incentives for quality care
  • Healthcare provider professionalism and partnership with patients, and
  • Access to appropriate care.

Outcomes and accountability

In addition, the ACC, through its Quality First campaign, supports quality efforts that increase transparency, focus on measurable outcomes and provide doctor accountability within care. The implementation and use of health information technology (HIT) is also critical. To this end, the ACC is working with members of Congress on HIT legislation currently making its way through the House and Senate. In addition, the College was instrumental in lobbying for the recent passage of the “Medicare Patient and Providers Act of 2008.” The new law, in addition to stopping cuts to Medicare physician reimbursement for 18 months, also includes an accreditation requirement for advanced imaging modalities and funds a two-year voluntary appropriateness criteria demonstration project supported by the ACC.

Over the last 60 years, the ACC has invested millions of dollars to support education, guidelines, quality improvement tools and programs, and national standards. We are considered a leader when it comes to creating clinical guidelines that are grounded in information collection and professional consensus. We also have the largest national cardiovascular data registry that currently collects and reports data back to hospitals and, more recently, individual practices to promote quality improvement.

Because of these successful efforts, the ACC has much to bring to the healthcare reform discussion. We know that healthcare reform needs to be about the quality of care we deliver—not the amount. Moving forward, we are committed to working with physicians, lawmakers, patients and other stakeholders to take quality care to the next level and move beyond process to focus on outcomes. When it comes to the healthcare system, quality cannot be an afterthought, but rather it must be embedded in everything we do. We have a responsibility to provide care that is patient-centered, evidence-based and cost-effective. While it’s not an easy task, it is one that is necessary for the future of healthcare in America.

In future issues of Cardiovascular Business, “The ACC Corner” will feature columns written by cardiovascular specialists across the country on issues related to practice management and health care reform. The goal is to educate and inform readers about the opportunities and resources available to improve patient safety and increase the value of care provided.

Jack Lewin, MD, is CEO of the American College of Cardiology.