House Subcommittee Looks to Physician Organizations for Innovative Payment Reform Models


The House Ways and Means Health Subcommittee explored physician organization efforts to promote high-quality patient care during a hearing held on July 24. The subcommittee has held a series of hearings examining Medicare physician payment reform ideas and has invited physician organizations at the epicenter of patient care to weigh in on payment approaches that reward quality, efficiency and patient outcomes. Registries were in the spotlight during the hearing and physician groups had the opportunity to demonstrate how data is being used to drive innovation.  

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Representatives from the American College of Physician Executives, American College of Physicians, American Gastroenterological Association, American Academy of Orthopaedic Surgeons Council on Advocacy, Quincy Medical Group and Sharp Community Medical Group testified during the most recent round of discussions.

The development of innovative new programs and payment models that reward physicians who deliver high-quality and efficient care has been a priority for the ACC over the last several years in light of health care reform and the need to curb out-of-control health care costs. On Feb. 7, the College had an opportunity to share outcomes of the efforts and discuss possibilities for the future during one of the Health Subcommittee hearings. The ACC testified about several of the exciting quality improvement collaborations underway in cardiology and what lessons can be applied across the health care system to simultaneously reduce unnecessary admissions, readmissions, complications, testing and ineffective spending.

The ACC shared its experience with the National Cardiovascular Data Registry (NCDR®) and the importance of decision support tools in helping care providers actually use evidence-based guidelines and appropriate use criteria to "get science to the point of care" to ensure not only the right therapy and/or test, but also engage patients in the decision making process. The testimony also focused on the ways the ACC is working to "put the data to work" through programs like Hospital to HomeImaging in FOCUS and PINNACLE. All three programs use data to identify areas for improvement and then provide networking and educational support for sharing of best practices and performance improvement. 

The ACC also testified on Medicare physician payments before the Senate Finance Committee on July 11. ACC Past President W. Douglas Weaver, MD, MACC, represented the College during the hearing, which addressed problems plaguing the current Medicare physician payment system and sought to identify new payment models and quality initiatives that incentivize high-quality and high-value care at reduced costs. This was a vital opportunity for the College, one of only five provider groups invited, to reiterate its long-term dedication to exploring innovative payment models in Medicare and abolishing the sustainable growth rate (SGR).

On July 19, Jerry D. Kennett, MD, MACC, testified on behalf of the ACC before the House Small Business Subcommittee on Oversight, Investigations and Regulations on the impacts of hospital and large practice integration on small and solo medical practices. Cardiology has been in the line of fire for payment reductions since 2007 and Kennett took this opportunity to urge the Committee to avert the nearly 30 percent scheduled Medicare reimbursement cuts, repeal the SGR and provide stable payments for several years to allow the development of new delivery and payment models.

Stay tuned to and The ACC Advocate and follow @Cardiology on Twitter for advocacy news and updates. 

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