Earlier this week the nation waited in anticipation as the American Taxpayer Relief Act of 2012 was passed through the Senate, and eventually through the House late New Year’s Day, therefore averting the so-called “fiscal cliff” from taking effect. The bipartisan deal included a one-year patch of the flawed Sustainable Growth Rate (SGR) formula, preventing Medicare payment cuts of 26.5 percent that were set to kick-in on Jan. 1. Across-the-board sequester cuts of 2 percent were also delayed, keeping Medicare reimbursement safe for another two months.

Throughout the past year, ACC leadership and staff helped lay the groundwork for several quality-related provisions in the new law through ongoing dialogue with congressional committees about ACC’s quality improvement tools, including registries. Included in the legislation, was an extension of the Geographic Work Adjustment through 2013 and reauthorization of funding for measure endorsement for another year. The ACC worked with the Stand for Quality coalition, including the National Quality Forum and the American Medical Association, to advocate for extension of this funding.

Also thanks to the incredible efforts of ACC’s Advocacy team, a provision to qualify registry programs to meet Physician Quality Reporting System (PQRS) reporting requirements was included. Professional society clinical data registries, such as the ACC’s National Cardiovascular Data Registry, collect robust data that are used to provide feedback to physicians and enhance performance. This focus on quality, evidence-based care by itself is an effective way to reduce overall costs while enhancing quality of care. Registry participation is a more robust performance improvement method than the current PQRS, and now that more physicians can meet PQRS requirements, physicians can avoid future penalties under the program. This provision was the result of discussions between ACC, the American Society of Clinical Oncology, the Society of Thoracic Surgeons, and a few other organizations with bipartisan staff for the Senate Finance Committee and House Ways and Means Committee in the summer and fall.

The College also played a key role in a provision to enhance the quality of data needed for new delivery and payment models. The law now requires the Secretary of HHS to develop a strategy to provide data for performance improvement to physicians in a timely manner. This provision is the direct result of testimony by physicians, including ACC Past President Doug Weaver, MD, MACC, before the Senate Finance Committee this summer as well, as a roundtable discussion between committee staff, ACC and several other specialties this fall.

While the offsets used to pay for the $25 billion SGR patch do result in an increase in the equipment utilization rate for advanced imaging modalities that is limited to CT/MR/PET, which will mean reduced payments, but fortunately ACC staff were able to keep prior authorization and changes to the in-office ancillary services exception kept out of the agreement.

Moving forward, ACC’s Senior Vice President Jim Fasules, MD, FACC, said it best when he told the ACC presidential team earlier this week  that while “the work now shifts to the spending cuts debate with a big spotlight on entitlements … right now we get to stop holding our breath.” It is now more important than ever that the cardiovascular community and the rest of the house of medicine build on the momentum from these efforts and continue to push for a permanent repeal of the SGR. As I mentioned in my blog post last week, 90 percent of ACC PAC-supported candidates (104) won their respective elections in November 2012, strengthening the College’s allies on Capitol Hill. These relationships and grassroots efforts have and will continue to be increasingly important as we work towards a permanent repeal over the next year. The ACC stands ready to work with Congress as it confronts the challenges and opportunities within Medicare.

Stay tuned to the ACC Advocate and CardioSource.org for additional details in the coming months.

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