The Center for Medicare and Medicaid Innovation (CMMI) on May 22 announced the award of a $15.8 million grant to support SMARTCare pilot projects designed by the ACC's Florida and Wisconsin chapters. The innovative pilots aim to reduce health care costs by providing tools to help doctors and patients communicate about options for their care while helping physicians apply the latest guidelines to the decision-making process.

SMARTCare brings together five tools to help physicians and patients work collaboratively to make decisions about the treatment of stable ischemic heart disease. The tools include the ACC's FOCUS program to support imaging decisions, shared decision-making resources, PRISM individualized patient consent for stent procedures, INDIGO individualized patient cardiac risk profile and the ACC's hospital-based CathPCI and outpatient-based PINNACLE registries.

"We believe involving patients in an evidence-based decision-making process is the best way to improve outcomes while providing the highest value for the health care dollar," said ACC President Patrick T. O'Gara, MD, FACC. "This grant will give us an opportunity to demonstrate how data from clinical registries can be leveraged to enhance physician/patient communication."

CMMI grants were established to foster health care transformation by identifying and supporting innovative models that establish new ways to pay for and deliver care that improve care while lowering costs. The SMARTCare model is expected to save 10 participating sites $42.2 million over the three-year pilot program, while also improving the decision-making process to benefit patients.

"The overarching goals of SMARTCare are to increase the percentage of stable ischemic heart disease patients with optimal risk factor modification and to reduce imaging procedures and percutaneous coronary interventions not meeting appropriate use criteria while achieving high levels of patient engagement and lower rates of complications," said Thomas Lewandowski, MD, FACC, SMARTCare project director and immediate past governor of the ACC's Wisconsin Chapter. "These are big goals, but we have the right people at the table to make them a reality."

While SMARTCare is focused on the treatment of coronary artery disease, moving forward it has the potential to be a model that could be applied across medicine and across the country.

"Our ability to utilize care patterns from separate states demonstrates how flexible and successful the program can be," said ACC Florida Chapter Governor Juan M. Aranda, Jr., MD, FACC. "We are hopeful that someday, patients from all over the country will be able to take advantage of the tools included in the SMARTCare program."

In addition to the Wisconsin and Florida ACC Chapters, SmartCare partners include ten health systems, five in Florida and five in Wisconsin, employer health care coalitions, insurers, patient and payment reform advisors and primary care groups.

"This model should motivate and inspire other specialists to achieve the same standard of care for their patients," said Tim Bartholow, MD, Chief Medical Officer, WEA Trust. "Physicians all over the country should be able to look to SMARTCare and apply it in their local facilities."

Keywords: Decision Making, Medicaid, Standard of Care, Health Care Costs, Risk Factors, Awards and Prizes, Indigo Carmine, Percutaneous Coronary Intervention, Stents, Registries, Delivery of Health Care, Physician-Patient Relations, Medicare

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