The U.S. continues to move toward a health care system that is focused on quality and value versus the current volume-based fee-for-service model. Passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) last April served to further this transition and will undoubtedly have an impact on the practice of medicine.

“The transformation from volume-based to value-based purchasing of health care used to be thought of by most of us as ‘five years away and always will be,’” said ACC President Kim Allan Williams Sr., MD, FACC, during his Opening Showcase Session address. “This is certainly no longer the case.”

At the broadest level, MACRA repealed the flawed sustainable growth rate formula used to calculate physician payment and established a definitive framework for moving Medicare from a volume to value-based system – a framework that private payers are already beginning to follow. As with many laws, however, MACRA is written with broad directions that will be implemented through more specific regulation by the federal agencies over the next few years.

Regardless, Williams noted that practice quality improvement efforts, quality reporting, and value-based reimbursement are here to stay, and will undoubtedly be a critical part of provider payment models regardless of how the details unfold. “The ACC is already at the table working to minimize challenges and take advantage of opportunities under the new system to support policies that facilitate evidence-based, cost-effective and high quality care,” he said.

Today’s James T. Dove Lecture featuring Harold D. Miller, president and CEO of the Center for Healthcare Quality and Payment Reform, will offer a closer look at this transition from volume to value and the role physicians and other health care providers can play going forward.

"Physicians must play the lead role in creating a higher-value health care system, because only physicians can redesign the way services are delivered to reduce spending without harming quality or access for patients,” says Miller. “Physicians don't need 'incentives' to deliver high-value care, they need a payment system that gives them the resources and flexibility to achieve better outcomes for their patients at lower costs for payers. Cardiologists must seize this opportunity to create a payment system that supports high-quality, affordable cardiovascular care."

Keywords: ACC Publications, ACC Annual Scientific Session, Delivery of Health Care, Fee-for-Service Plans, Medicare, Physicians, Quality Improvement, Quality Indicators, Health Care, Value-Based Purchasing, Medicare Access and CHIP Reauthorization Act of 2015

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