First Word: Politics & Cardiology Practice Collide

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 - C.P. Kaiser

On March 10, the American College of Cardiology (ACC), along with more than 130 U.S. medical organizations and societies, sent letters to the House of Representatives and the Senate urging lawmakers to replace the flawed sustainable growth formula (SGR) with a "workable system that keeps pace with practice costs and ensures … high-quality care."

The letter details the five temporary SGR "fixes" Congress enacted last year, until a bipartisan bill was passed to keep physician payment rates consistent through 2011. But that means that the SGR must still be dealt with for the 2012 budget. Signatories of the letter say that the elimination of the SGR should be one of Congress' highest priorities.

Also on March 10, the CMS announced that the reimbursement cut set to occur on Jan. 1 would be 29.5 percent—"the highest ever scheduled," according to Dr. Cecil B. Wilson, president of the American Medical Association.

In the announcement, Jonathan Blum, CMS deputy administrator and director, noted that the current fix to the SGR is not a long-term solution. "We will continue to work with Congress to fix this untenable situation so doctors no longer have to worry about the stability and adequacy of their payments from Medicare," Blum says.

In March, we also saw a flurry of activity regarding the Patient Protection and Affordable Care Act (PPACA). A Florida judge ruled it unconstitutional and the Justice Department filed an appeal. In the meantime, the Obama Administration has suggested that each state might be able to apply for certified state waivers from the PPACA.

Whether any or all of this is political jockeying remains to be seen. One thing for certain, however, is the need for cardiologists and cardiology practices to produce better patient outcomes, increase efficiency and improve performance. Evidence-based medicine is setting the stage for a more personalized approach to treatment, and health informatics is leading the charge for improvement.

In this issue of Cardiovascular Business, we highlight areas in cardiovascular care where research has revealed ways to better treat the individual. Whether it's CABG, angina, stenting or atrial fibrillation, the trend is to tailor care based on particular patient characteristics, be they genetic, gender or anatomical considerations.  

Despite the hazy political picture associated with medical practice, the focus on the patient remains at the forefront. Let us know how you are navigating these waters.