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Amanda Jekowsky , American College of
Cardiology, 202-375-6645, ajekowsk@acc.org
July
28, 2009
ACC Positions Quality at Center Of Health Care Reform
Vision: the right cardiovascular care for the
right patient at the right time
The American College of Cardiology (ACC)—long at the
forefront of quality initiatives—is taking a leading
role in health care reform. In partnership with patients,
lawmakers and payers, the ACC is setting a new standard for
health care delivery, one that centers on increasing the quality
of care and ensuring greater patient access and value.
A paper published in the August 4, 2009, issue of the Journal
of the American College of Cardiology (JACC) lays out
the College’s vision, describing both existing initiatives
and plans for the future. It calls for cardiologists to step
forward and play an active role in shaping health care reform.
“Under the organizing principle of ‘Quality First,’
the ACC is encouraging health care providers to act on their
professional responsibility and transform health care from
the inside out,” write the editorial’s authors,
James T. Dove, M.D., and W. Douglas Weaver, M.D., both past
presidents of the ACC, and Jack Lewin, M.D., the ACC’s
chief executive officer.
Over the last 60 years, the ACC has become a recognized leader
in physician education and quality. Through clinical guidelines,
appropriate use criteria, performance measures, process measures
and the National Cardiovascular Data Registry (NCDR), the
ACC provides powerful tools for guiding clinical decision-making
and improving patient care. Now it is helping to define the
physician’s role on the front lines of health care reform.
“We must remain focused, involved, and prepared to
lead,” the authors write. “It is our responsibility
to ensure any reforms are practical and appropriate for cardiovascular
patients and practices.”
Death rates from cardiac disease and stroke have plummeted
by 60 percent and 70 percent, respectively, over the past
30 years, thanks to public awareness and new medications,
devices and treatment strategies. But not everyone has access
to high-quality health care in this country. In fact, more
than 46 million Americans have no health insurance, and at
least as many are under-insured. In addition, there are wide
variations across the country in outcomes, quality and the
use of medical resources.
As a result, the momentum for health care reform is rapidly
growing. The ACC, in its commitment to high-quality cardiovascular
care for all patients, has endorsed six principles necessary
for health care reform, including:
- Universal coverage
- Coverage through an expansion of public and private (pluralistic)
programs
- Focus on patient value—transparent, high-quality,
cost-effective, continuous care
- Emphasis on professionalism, the foundation of an effective
partnership with empowered patients
- Coordination across sources and sites of care
- Payment reforms that reward quality and ensure value
Several steps must be taken to put these principles into
action. For example, to be effective, health care reform must
foster not only a renewed focus on measurable health outcomes
but also a reduction in legal and defensive medicine costs.
Health information technology is also key to improving quality,
enhancing coordination of care, reducing duplication and improving
efficiency. To be successful, however, information systems
must be interoperable and provide decision support tools at
the point of care.
Similarly, payment systems must be redesigned with the patients’
interests in mind, rewarding quality of care and best practices,
rather than simply the number of patient contacts. The ACC
favors payment reform that rewards those who focus on total
patient care and prevention, supports team-based care, and
encourages the appropriate use of tests and procedures.
The ACC has developed a series of action plans aimed at making
major contributions in both cardiovascular care and overall
health 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 prevention
of cardiovascular disease.
“We must take responsibility for reducing the high
costs that we can control such as those associated with duplication,
overuse, and a lack of coordination of care,” the authors
write. “We must also address the underuse and failure
to adhere to proven medical regimens. We can do better and
must become good stewards in the use of health care resources.”
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The American College of Cardiology is leading the way to optimal
cardiovascular care and disease prevention. The College is
a 36,000-member nonprofit medical society and bestows the
credential Fellow of the American College of Cardiology upon
physicians who meet its stringent qualifications. The College
is a leader in the formulation of health policy, standards
and guidelines, and is a staunch supporter of cardiovascular
research. The ACC provides professional education and operates
national registries for the measurement and improvement of
quality care. More information about the association is available
online at www.acc.org .
The American College of Cardiology (ACC) provides these news
reports of clinical studies published in the Journal of
the American College of Cardiology as a service to physicians,
the media, the public and other interested parties. However,
statements or opinions expressed in these reports reflect
the view of the author(s) and do not represent official policy
of the ACC unless stated so.
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