The ACC Corner: New Year Brings Opportunities for Bipartisan Reforms

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 - Jack Lewin, MD
Jack Lewin, MD

The New Year provides an opportunity to turn a corner and not look back. At the American College of Cardiology (ACC), our initial focus is to apply all means necessary to mitigate the impacts of the 2010 Medicare Physician Fee Schedule rule, which resulted in drastic payment cuts for cardiology. The rule is bad policy. It will not only hurt access to care, particularly for disadvantaged populations, but will dramatically increase Medicare costs by shifting services to the hospital setting. The college is working all angles—regulatory, legislative and legal—to reverse the most egregious elements of the rule.

Simultaneously, the college is working with multiple stakeholders to develop and implement an improved payment methodology to avoid this Medicare payment nightmare again. Given the roughly 30 percent reduction in morbidity and mortality from cardiovascular disease over the last decade, cardiology would fair well under a system that rewards—not penalizes—physicians and other medical professionals for their commitment to quality and evidence-based care.

However, in order to realize the benefits of a new system, we need to take advantage of the opportunities for creativity within the healthcare reform arena. We need to put aside the partisan rhetoric, cynicism and understandable frustration to focus on developing, testing and implementing systems that will promote our best future, protect our practices and ensure patient access to quality care.

The challenge of making positive change requires a more discerning, bipartisan course. Cardiovascular professionals continue to be viewed as leaders when it comes to finding new ways to bridge the gaps between science and practice. We have the opportunity and ability to influence leaders on both sides of the aisle on issues, about which the vast majority of Americans are concerned. In fact, we’re already working to ensure proper use of diagnostic equipment; promote adherence to clinical guidelines and appropriate use criteria; improve care coordination through the use of clinical registries; and reduce hospital readmissions and geographic variations.

Americans mainly want some prudent reform to protect their ongoing access to quality, affordable healthcare. We can help get there, provided we focus on the merits of each issue as they come before us. If we can do that, we’ll be staying close to our patients and the public in the mainstream—where we need to be to survive. While we might not like a lot of provisions in the current 2,000-page healthcare reform bill, some provisions in the bill are sorely needed as well.

The status quo in healthcare is unsustainable and a fiscal nightmare. Doing nothing is not a responsible course that real leaders in healthcare should recommend. The ACC has tried to find a path through the reform quagmire that truly meets the needs and goals of the cardiology community, while also protecting the patient-physician relationship. To just say no, or to take a purely partisan stance, is not responsible.

Finding a balance is what we need to do together. Now is the time for us to ask our patients, staff and colleagues what is needed in order to work to meet those needs. Some kind of health reform bill is almost certain to be passed. We can either work to make it better, or we can stand by and watch it happen. I, an eternal optimist, would like to see us enact some real change and help influence what that change will be.

For more information on ACC’s healthcare reform efforts visit qualityfirst.acc.org. Information on ACC’s efforts to fight the 2010 Medicare payment cuts is available at www.campaignforpatientaccess.org.