The ACC Corner | ACC Approves Blueprint for Healthcare Reform

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

The American College of Cardiology held its successful 58th Annual Scientific Session in Orlando, Fla., in March. The event featured exciting science, quality improvement programming and critical networking opportunities for the entire cardiovascular community. In addition, the meeting provided an opportunity for the college to re-affirm its commitment to leading healthcare reform.

Over the last few years, the ACC has been working to educate and engage patients, lawmakers, payers and others in the medical community around a new standard of healthcare delivery focused on increasing the quality of care and ensuring greater patient value. During the meeting, the college took this commitment to the next level by approving a “blueprint” for reform, including six guiding principles and a series of action plans to implement those principles.

Under the organizing principle of “Quality First,” the ACC has developed six principles essential to a reformed system: universal coverage, expansion of coverage through public/private programs, a focus on patient value (transparent, high-quality, cost-effective, continuous care), professionalism and partnership with empowered patients, coordination across sources and sites of care, and payment reforms that reward quality and ensure value.

While coverage and financing are extremely important, cardiovascular professionals can have the most impact on the last four principles, which focus on reforming delivery and payment systems to improve quality of care. A renewed focus on outcomes, commitment to adoption and use of health information technology and a reduction in legal and defensive medicine costs are necessary to successfully implement these principles.

In addition to its healthcare reform principles, the ACC also has developed a series of action plans in areas in which it believes the college can make major contributions in both cardiovascular care and overall system reform. The plans focus on reducing cardiovascular-related hospital readmission rates, limiting inappropriate imaging, reducing geographic variations in care, encouraging adherence to guidelines, partnering on patient-centered medical home models, ensuring transparency and professionalism, testing payment models that reward quality, and increasing primary and secondary prevention through medication adherence and lifestyle choices. 

Primed for reform

If you believe leading healthcare economists like Uwe Reinhardt of Princeton University and Len Nichols of the New America Foundation—both of whom provided keynote lectures in Orlando—the U.S. healthcare system is primed for reform and the current economic crisis, while an impediment, also has created an opportunity to focus on priorities. Both men will tell you that healthcare is becoming increasingly unaffordable to average Americans. In addition, employer costs are growing and there are wide variations across the country in terms of outcomes and quality of care. Even more importantly, the incentive structure must be a focus of change.  

The ACC firmly believes that carefully crafted partnerships among patients, the Centers for Medicare & Medicaid Services (CMS), Congress, the Obama administration and willing professional societies are critical to enacting real reforms and expediting the progress needed. Each of the college’s principles and proposed pilots is designed to move the cardiovascular community—and the nation as a whole—closer to ensuring the right care, to the right patient, at the right time. 

Over the rest of the year, the greatest challenge for both the college and the medical community will be to remain nimble in the face of change. Healthcare reform will likely require physicians and care providers to adjust the way they practice. Ultimately, we must remain committed to doing what is right for patients as we participate in the great effort to reform healthcare.

For more on the ACC’s healthcare reform efforts, go to qualityfirst.acc.org. You also can share your thoughts on healthcare reform at the Lewin Report blog: lewinreport.acc.org.