ACC.14: Cardiologists can take leadership roles in ACOs

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WASHINGTON, D.C.—Cardiology appears to be tailor-made for value-based healthcare models such as accountable care organizations (ACOs). “Cardiology fits better than any other specialty because we are the most integrated specialty,” cardiologist C. Michael Valentine, MD, said March 29 at the American College of Cardiology scientific session.

Models such as ACOs emphasize efficient, integrated, coordinated care, an aligned purpose and physician leadership with primary care physicians at the core. They require measurable metrics, an EMR and, for a Medicare ACO, at least 5,000 patients.   

“This is the Mayo Clinic on steroids,” said Valentine, an interventionalist at Stroobants Cardiovascular Center in Lynchburg, Va. The ACO needs an integrated practice management system, integrated outpatient and inpatient systems, common data collections, storage capacity and analytical might.

The need for these resources makes small, rural practices unlikely candidates for ACOs; on the other hand, large entities such as insurers can and are forming ACOs, he said.

About 25 percent of physicians already belong to ACOs, and 15 percent are planning or enrolling in ACOs. The areas with the most intensity hug the East and West Coasts.

“We are forming an ACO right now in preparation of an integrated system,” he said. Stroobants is under the umbrella of the Centra Medical Group, a health system that includes three hospitals and more than 150 physicians and specialists.

Cardiologists fit seamlessly into the ACO model because they already have invested in the skills and infrastructure at the foundation of ACOs. The specialty is data driven and has embraced quality metrics and electronic records, he said. In addition, 70 percent of cardiologists in the U.S. are already integrated.

He predicted that cardiologists will hold leadership roles in ACOs because they have demonstrated how to run data systems, improve quality, apply appropriate use criteria and analyze variability. Citing the decrease in PCIs, he asked, “What other specialty has shown an actual drop in utilization because of quality? Almost none. We have the wherewithal to do it; we have the drive to do it; and we have the physicians.”