By Michael Mansour, MD

The ACC is in the implementation phase of its 5-year strategic plan, which details goals and aspirations in six key areas, including the specific call to expand advocacy efforts. The plan hones in on this expansion particularly among payers and state policymakers in order to position the College as a leading voice in shaping public policy. ACC Advocacy seeks to advance the College's mission of improving the cardiovascular well-being of the nation through interactions with Congress, federal government agencies, state legislative and regulatory bodies, private insurers, and other policy-making groups.

Our ACC Chapters, which represent all 50 states and Puerto Rico, are our frontlines and have a distinct advantage in connecting with those who determine policy. Grassroots efforts, such as action alerts and legislator practice visits, are crucial for building relationships with lawmakers and shaping health policy. Since the beginning of 2014, nearly 70 meetings have taken place between ACC members and legislators.

Ultimately, advocacy is about patient access to appropriate and timely care. Patient access to the provider and facility of their choice determines, to a great extent, a patient's ability to receive appropriate care in a timely and convenient manner. In addition to being the right way to deliver care, timely and convenient access to care plays a critical role in combating health care disparities for underserved and minority populations. 

Advocacy is also about forming alliances; these alliances with other medical societies and medical associations are critical to effective advocacy. While some of these alliances are formed at the national level, many of the most effective alliances are forged at the state level. Forming alliances by participating in state medical associations can increase the voice of cardiology 20- to 30-fold. This synergy facilitates advocacy at the state level for many issues important to cardiology, including matters involving preventive health measures (such as smoke-free public places, proper nutrition in schools, and healthy lifestyle education programs), funding for graduate medical education, and promoting proper utilization of and appropriate access to health services.

When it comes to effective advocacy, chapters in states like Maryland and California have seen the fruits of their labors flourish over the last few years. The ACC Maryland Chapter worked extensively for 2 years to develop an oversight system for all state hospitals performing percutaneous coronary intervention (PCI). This resulted in a momentous win for the Chapter, as the Maryland Legislature passed a bill in May 2012 requiring a state agency to develop requirements for peer or independent review—consistent with the ACCF/AHA/SCAI guidelines for PCI—of difficult or complicated cases and for randomly selected cases for Maryland hospitals.

Similarly, in 2014, the ACC's California Chapter led a grassroots campaign aimed at defeating California Senate Bill 1215, an imaging bill that sought to remove the in-office ancillary services exception for advanced modality imaging and many other services. In May 2014, the bill was defeated. These are just two examples of grassroots advocacy and the strength of ACC chapters; there are many more powerful cases throughout the states that serve as reminders for why the ACC has put such a focus on advocacy for the next 5 years.

In mid-September, nearly 400 ACC members will gather in Washington, DC for ACC's annual Legislative Conference—arguably the most important in-person health policy and advocacy gathering of the year for the College. The event is complete with sessions designed to arm the entire cardiac care team with information and tools necessary to create positive change on both the state and national level. The conference is capped off with an incredibly memorable and impactful experience on Tuesday, where ACC members head to Capitol Hill for pre-arranged meetings with members of their congressional offices. This is a critical time for the ACC to let our voice be heard by our lawmakers.

Chapters are the key to the College's grassroots advocacy goals. It is with them that we will be able to move the impact needle, state by state, for our colleagues and—most importantly—for cardiovascular patients.

Michael Mansour, MD, is chair of the ACC’s Board of Governors.