Alfred Bove, M.D., President, American College of Cardiology

American College of Cardiology

Transforming Science into Quality Care

ACC Mission

“The mission of the American College of Cardiology is to advocate for quality cardiovascular care—through education, research promotion, development and application of standards and guidelines—and to influence health care policy.”

Overarching Goals

Turn CV knowledge into practice Increase the value of membership Promote strong practices and

protect patient access to quality, evidence-based, continuous care

The ACC is recognized as a leader in the development of an evidence-based quality platform

(QCARE).

The ACC’s 37,000 members are committed to patient-centered quality care around the world

QCARE

Science

Education

Evaluation

Standards

Decision Support/EMR Technology

Measurement (NCDR)

Quality Initiatives

QPatient Centered

Care

QCARE in Action

Improvement•D2B•H2H

Measurement•NCDR

Implementation - “Bridge”•Care Plans•Wall Charts•Standard Orders•Pocket Guides•EHRs with decision support tools

Guidelines/Standards•Guidelines•Appropriate Use Criteria•Performance Measures

Do

Plan

Study

ActEducation

&Training

Education&

Training

“Science tells us what we can do;Guidelines what we should do;

Registries what we are actually doing.”

Registries

CathPCI

ACTION-GWTG

CARE

ICD

Registry Studies

ICD Long.

AnalyticReporting Services

BCBSAWellPoint

UnitedWVMI

HCA

CMS

BMC2Research &

Publication ServicesYale

DCRI

MAHI

FDA ACC

Ad hocIndustry

IMPACT

Quality Improvement

What is the National Cardiovascular Data Registry?

Aetna

SPECT MPI

IC3

Standard Order Sets

Care Plans

• Guidelines Develop.• Educational Needs

Assess.• Market Intelligence

ACC

Uses of Registry Data Quality Improvement

• Effectiveness of P4P• Guideline adherence• Performance measure development,

implementation, validation Post Market Surveillance

• Adverse/sentinel events • Identify device performance trends• Inappropriate off-label use• Hypotheses for follow up studies

Appropriate Use Criteria

• SPECT MPI (Updated May 2009)

• CCT

• CMR

• TTE/TEE

• Stress Echocardiography

• Coronary Revascularization

Taking the Quality Platform to the Next Level …

Health Care Reform

• Current environment is not sustainable

• Continued payment cuts threaten practices and patient care

• Need to be at the table not on the menu

Why Health Care Reform?

ACC Principles for Reform

1. Provides universal coverage2. Provides coverage through an expansion

of public and private programs3. Focuses on patient value (transparent,

high quality, cost-effective, continuous care)

4. Emphasizes professionalism5. Ensures coordination across sources

and sites of care6. Includes payment reforms that reward

quality and ensure value

ACC Action Plans for Reform

1. Reduce CV hospital readmission rates

2. Increase appropriate imaging

decision support at point of care

3. Reduce geographic variations in care

4. Test payment models that reward quality

5. Increase adherence to guidelines

6. Make quality operational

• Share best practices• Learn and teach• Deploy QI initiatives based on practice needs• Implement Appropriate Use Criteria• Use interoperable electronic systems to:

– exchange data – deliver decision support – reduce errors and waste

Quality First Network

ACC Action Plans for Reform

7. Partner on patient-centered medical home models

8. Increase primary and secondary prevention through medication adherence and lifestyle

9. Ensure transparency

10. Empower patients

11. Ensure professional competence

12. Seek opportunities to promote tort reform

Hospital to Home

• ACC and Institute for Healthcare Improvement (IHI) quality improvement initiative

• Goal: “excellence in transitions”

• Reduce 30-day hospital readmission rates for HF or AMI by 20% by 2012

• For more info: www.acc.org/h2h/enrollment

On the Legislative Front …

The ACC is working with Congress to:

Replace flawed formula with more sustainable system that reflects increases in practice costs and accounts for appropriate growth in services

Test models that seek to reduce variations in spending and ensure patients receive evidence-based care

On the Payer Front …

The ACC is working with CMS and private payers to: Help fund registries and procure aggregate

data Provide incentives to clinicians for participation

in registries and electronic reporting Encourage use of appropriate use criteria as

an alternative to prior authorization/pre-certification

Future System Should Reward …

Fee-for-Service + episodes of care Coordination of care Registry Use Adherence to guidelines Measured Performance Improvement

Where’s the Patient in this Discussion?

“The best interest of the patient is the only interest to be considered.”

-- William Mayo

ACC’s “Year of the Patient”

Goals: Increase transparency and accountability – at

every step of the process Better communicate diagnosis and treatment

options so patients can understand/participate in care decisions

ACC’s “Year of the Patient”

Tactics: Develop online and office-based patient

materials and tools (ie: blood pressure monitoring)

Work with Chapters and other partners to hold patient events/Webinars on heart health and related issues

Contact ACC

• ACC Website: www.acc.org

• ACC Phone Number: 800-253-4636