American College of Cardiology

1. American College of Cardiology Transforming Science into Quality Care

2. ACC Mission “The mission of the American College of Cardiology is to advocate for quality cardiovascular care—through education, research promotion, development and application of standards and guidelines—and to influence health care policy.”

3. Overarching Goals • Turn CV knowledge into practice • Increase the value of membership • Promote strong practices and protect patient access to quality, evidence-based, continuous care

4. The ACC is recognized as a leader in the development of an evidence-based quality platform (QCARE). The ACC’s 37,000 members are committed to patient-centered quality care around the world

5. QCARE

6. QCARE in Action

7. “Science tells us what we can do;Guidelines what we should do; Registries what we are actually doing.”

8. What is the National Cardiovascular Data Registry? • Guidelines Develop. • Educational Needs Assess. • Market Intelligence Analytic Reporting Services Registries WellPoint CMS BCBSA CathPCI IMPACT WVMI United ACC BMC2 Aetna ICD IC3 Research & Publication Services HCA CARE FDA Yale ACC ACTION-GWTG Industry DCRI Adhoc MAHI Registry Studies Quality Improvement SPECT MPI Care Plans Standard Order Sets ICD Long.

9. Uses of Registry Data Quality Improvement Effectiveness of P4P Guideline adherence Performance measure development, implementation, validation Post Market Surveillance Adverse/sentinel events Identify device performance trends Inappropriate off-label use Hypotheses for follow up studies

10. Appropriate Use Criteria • SPECT MPI (Updated May 2009) • CCT • CMR • TTE/TEE • Stress Echocardiography • Coronary Revascularization

11. Taking the Quality Platform to the Next Level …Health Care Reform

12. Why Health Care Reform? • Current environment is not sustainable • Continued payment cuts threaten practices and patient care • Need to be at the table not on the menu

13. ACC Principles for Reform • Provides universal coverage • Provides coverage through an expansion of public and private programs • Focuses on patient value (transparent, high quality, cost-effective, continuous care) • Emphasizes professionalism • Ensures coordination across sources and sites of care • Includes payment reforms that reward quality and ensure value

14. ACC Action Plans for Reform • Reduce CV hospital readmission rates • Increase appropriate imaging • decision support at point of care • Reduce geographic variations in care • Test payment models that reward quality • Increase adherence to guidelines 6. Make quality operational

15. Quality First Network • Share best practices • Learn and teach • Deploy QI initiatives based on practice needs • Implement Appropriate Use Criteria • Use interoperable electronic systems to: • exchange data • deliver decision support • reduce errors and waste

16. ACC Action Plans for Reform • Partner on patient-centered medical home models • Increase primary and secondary prevention through medication adherence and lifestyle • Ensure transparency • Empower patients • Ensure professional competence • Seek opportunities to promote tort reform

17. Hospital to Home • ACC and Institute for Healthcare Improvement (IHI) quality improvement initiative • Goal: “excellence in transitions” • Reduce 30-day hospital readmission rates for HF or AMI by 20% by 2012 • For more info: www.acc.org/h2h/enrollment

18. On the Legislative Front … The ACC is working with Congress to: • Replace flawed formula with more sustainable system that reflects increases in practice costs and accounts for appropriate growth in services • Test models that seek to reduce variations in spending and ensure patients receive evidence-based care

19. On the Payer Front … The ACC is working with CMS and private payers to: • Help fund registries and procure aggregate data • Provide incentives to clinicians for participation in registries and electronic reporting • Encourage use of appropriate use criteria as an alternative to prior authorization/pre-certification

20. Future System Should Reward … • Fee-for-Service + episodes of care • Coordination of care • Registry Use • Adherence to guidelines • Measured Performance Improvement

21. Where’s the Patient in this Discussion?

22. “The best interest of the patient is the only interest to be considered.” -- William Mayo

23. ACC’s “Year of the Patient” Goals: • Increase transparency and accountability – at every step of the process • Better communicate diagnosis and treatment options so patients can understand/participate in care decisions

24. ACC’s “Year of the Patient” Tactics: • Develop online and office-based patient materials and tools (ie: blood pressure monitoring) • Work with Chapters and other partners to hold patient events/Webinars on heart health and related issues

25. Contact ACC • ACC Website: www.acc.org • ACC Phone Number: 800-253-4636