Despite stunning technological and therapeutic advances in U.S. health care in the past two decades, the precipitous increases in health care spending have led to stronger efforts by Congress, state and federal regulators, payers and others to look at ways to control costs. Real solutions to these problems exist, but policymakers are widely divided along party lines, which has created grid-lock in moving toward viable “middle of the road” strategies to both improve care and reduce spending. The question then becomes: Is there a role for cardiology in helping to find that middle ground?
A September 2011 CardioSurve survey attempts to answer this question by providing a glimpse at the issues that are top-of-mind for cardiovascular professionals. Even more importantly, the survey looks at the specific policy areas where cardiovascular professionals feel the American College of Cardiology (ACC) can play a major role in bringing about change, and other areas, while still important, where the College’s contributions may not be as effective.
Overall, the issues ranking highest in terms of relevance to cardiovascular practices include repealing the flawed Sustainable Growth Rate (SGR) formula used to calculate Medicare physician payment (71%); transitioning the current fee-for-service payment system to one that lowers costs and rewards improved care coordination and outcomes (57%); finding a middle ground on Medicare reform (57%); and advocating for federal medical liability reforms (51%). Further analysis reveals that private practice members are most interested in a repeal of the SGR (85%) and Medicare reform (70%); however, transitioning from fee-for-service (57%) was the highest priority for those not in private practice.
In terms of ACC impact, survey respondents ranked advocating for ongoing funding for public health prevention, research and innovation (45%), transitioning from fee-for-service (38%), and advocating to reform medical liability (38%) as the areas where the ACC can make the greatest contributions. In terms of repealing the SGR formula, members are divided. Slightly more than 1 out of 3 members (36%) believe that ACC can make a strong contribution to repealing SGR, however, a considerable block of members (20%) feel that the ACC will have less of an impact on it. Similarly, the members are split on the impact that the ACC can have on finding a middle ground on Medicare reform. More than 1 out of 4 (29%) members believe that the ACC can make a positive difference on Medicare reform, while approximately 1 out of 6 (16%) members feel that the ACC has less likelihood to contribute to its reform.
When it comes to advocating for the cardiovascular profession regarding health reform implementation, nearly 60% of ACC members believe the College is doing a good job. Broken down by practice setting, 55% of private practitioners gave the College high marks, compared to 62% of respondents not in private practice. Data from the survey suggest that the ACC can further build on this success by prioritizing its resources to focus on transitioning from the current fee-for-service payment model. In addition, continuing to advocate for research and prevention funding will resonate with non-private practitioners, while finding a middle ground on Medicare reforms and working to ensure federal medical liability reforms will appeal to those in private practice.