ACC Board of Governors MeetingSeptember 2010
Jim Fasules, MD FACC SVP AdvocacyThe American College of Cardiology
Health Reform et al:Where we are now
Healthcare Reform: Hollywood on the Potomac
Reform Started with ARRA
$1.1B for CER (PCOR)
$36B for HITMeaningful use
$44,000 - $66,000 for MDs
Misinformation – “death panels”
ACC Principles for Reform
1. Provides universal coverage; +++2. Provides coverage through an expansion of both
public and private (pluralistic) programs; +++
3. Focuses on patient value — transparent, high quality, cost-effective, continuous care; +
4. Emphasizes professionalism, the foundation of an effective partnership with empowered patients;
5. Ensures coordination across sources and sites of care; +
6. Includes payment reforms that reward quality and ensure value. ?
Healthcare Reform: Role of Cardiology
Avoid spin and disinformation
“Lies, damn lies, statistics” Disraeli
“Lies, damn lies, and extreme partisan rhetoric” Fasules
“Don’t trust, verify” after Reagan
Other BIG issues we face…
“Reform 2010”: the Rule and the RUC
SPECT MPI cut 36% after ECHO cuts and lower PE
The “Rule” – Where are we now?
Cliff Happened!!!!
RBM Onslaught on “self-referral”
Critical Issues Lie Ahead
• ACOs and Payment Reform
• Public Reporting
• Maintenance of Certification
• Primary Care - PCMH?
• Physician Employment
ACC Advocacy: Creating Change
“We in America do not have government by the majority. We have government by the majority who participate”
Thomas Jefferson, 1787
ACC Board of Governors MeetingSeptember 2010
Jack Lewin, M.D., CEOThe American College of Cardiology
Health Reform:What Lies Ahead
A crack in the crystal ball
Controlling the future?
The Bullish Forces
PPACA
The beginning or result of health reform?
The pressure for cost containment and fair
competition in a global economy
The pressure for integration and consolidation
• Physicians, hospitals and insurers• ACOs• Vertical vs. horizontal integration
The pressure for physician employment
• AMA estimates• ACC estimates• Impacts on professional societies• Vertical vs. horizontal integration
The pressure to move away from fee-for-service
reimbursement• Payment reforms• PCMH (patient centered medical home)• Government strategy
The pressure for delivery system reform
• EHRs and Meaningful Use• Care coordination• Prevention and chronic disease
management• H2H, etc.
The pressure to create patient financial incentives related to
health care costs• Employer actions• Government actions• Co-pay incentives• Preferred networks, Centers of Excellence
and CPIP/CPR
The pressure to improve population health
Risks and Opportunities
Causes for Cautious Optimism
PINNACLE and NCDR
FOCUS and AUC
CPIP/CPR
ACC Science, Education, LLL, POC Innovation
Uniting a fragmented profession
