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ACC Leaders, Other Stakeholders Explore Challenges to Cardiology Integration in Value-Based Care

Stakeholders from cardiology, health systems, government and industry joined together to explore the challenges and evaluate potential solutions to integrating cardiovascular specialists into value-based care at the ACC's annual Value-Based Care in Cardiology Forum on Nov. 30.

The theme of this year's Forum was how to identify high-value cardiovascular specialists and showcased examples of primary care and cardiovascular care engagements. Participants were invited to learn from and challenge each other so that takeaways from the meeting were rooted in addressing the needs of the clinician, payer, health system, and most importantly, the patient.

"With an aging U.S. population, and health care spending estimated at $4.7 trillion in 2023, interest in moving from fee-for-service to value-based payment models is accelerating," said Paul N. Casale, MD, MPH, MACC, co-chair of the Forum's planning committee. "As cardiovascular specialists, it is important that we engage with the move to value-based care to ensure high-quality, coordinated care for our patients, who commonly have multiple chronic conditions."

The Forum featured a keynote address by Elizabeth Fowler, JD, PhD, director of the Center for Medicare and Medicaid Innovation (CMMI), who outlined the agency's goals to rethink the regulatory framework of fee-for-service to focus more on rewarding providers based on outcomes and quality improvement. Her overview touched on the importance of incentivizing primary care providers and specialists to work together in value-based care arrangements.

Fowler also emphasized CMMI's ongoing commitment to health equity, adding that as more practices and health systems move toward value-based models encouraging team-based care, the more equitable and accessible their care will be.

The program also featured a panel discussion comparing different perspectives on high-value cardiovascular care and spotlighting existing efforts to promote collaboration between primary and specialty care and use health care analytics and relevant performance data to support clinicians, practices, accountable care organizations and health plans.

The meeting closed with a case study of a specialty risk-sharing arrangement, exploring the challenges in developing fair contractual components for all parties involved. Representatives from Cardiology Consultants of Philadelphia, Tandigm Health and Independence Blue Cross discussed the intricacies of their arrangement and the benefits to patients in terms of timely access to cardiovascular services.

"Working collaboratively and engaging with clinicians, payers, employers and other stakeholders is a fundamental component of the College's advocacy efforts to transition to improved care models that strengthen value and patient outcomes," said ACC President B. Hadley Wilson, MD, FACC. "The Value-Based Care Forum provides an opportunity to support these activities and further 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 toward value together."

For more on ACC Advocacy's framework for long-term payment reform and its value-based components, access ACC's Vision For Championing Patient Access to Care.

Keywords: ACC Advocacy, Medicare, Medicaid, Quality Improvement, Accountable Care Organizations, Health Equity, Multiple Chronic Conditions, Health Expenditures, Government, Primary Health Care

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