Working collaboratively and engaging with clinicians, payers, employers and other stakeholders is a fundamental component of ACC Advocacy efforts aimed at helping to lead the transition to improved care models that strengthen value and patient outcomes. Over the past two years, the College's Value-Based Care in Cardiology Forum has provided an opportunity to support these efforts and foster ongoing discussions around the refinement and/or creation of payment models that prioritize the clinical quality of care to the patient and allow all members of the health care delivery system to move towards value-based care together.

The most recent forum held in December 2020 explored opportunities to develop new payment models focused on the care of patients who have been recently diagnosed with atrial fibrillation (AFib). Chaired by Paul N. Casale, MD, MPH, FACC, the Forum offered a clinical and claims-data review of the AFib population, while also allowing for open discussions about the roles of the care team in AFib management as well as opportunities to improve value within the context of a longitudinal, condition-focused model.

A top theme that emerged from the Forum included definitive interest among stakeholders in developing condition-based payment model(s) with the goal of improving all aspects of care. However, attendees noted the need to develop and achieve consensus around the care model first and cautioned against letting the payment model drive the delivery system. There was also agreement around the essential need for collaboration between primary care and the cardiovascular team when it comes to any AFib care model, with potential shared risk and reward. Attendees also flagged the heterogeneity of the AFib population as a challenge to developing a payment model and stressed the need for more direction when it comes to follow-up care, as well as the importance of addressing barriers to anticoagulation given current gaps in care and health equity.

Coming out of the Forum, the Planning Committee is working to further develop the themes and build frameworks for operationalizing the two main recommendations over the course of this year. The recommendations involve: 1) defining and developing an evidence-based, team-based care model for new-onset AFib; and 2) identifying appropriate payment model(s) once care model(s) and local scenarios are created. In addition, the College will continue to leverage these insights and build upon the conversations over the last two years to help inform its ongoing APM work.

 

Clinical Topics: Anticoagulation Management, Arrhythmias and Clinical EP, Cardiovascular Care Team, Anticoagulation Management and Atrial Fibrillation, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: ACC Publications, Cardiology Magazine, Atrial Fibrillation, Aftercare, Consensus, Goals, Motivation, Delivery of Health Care, Primary Health Care, Health Services, Reward, Quality of Health Care, Anticoagulants

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