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American College of Cardiology
Transforming Science into Quality Care
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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.”
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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
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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
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QCARE
Science
Education
Evaluation
Standards
Decision Support/EMR Technology
Measurement (NCDR)
Quality Initiatives
QPatient Centered
Care
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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
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“Science tells us what we can do;Guidelines what we should do;
Registries what we are actually doing.”
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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
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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
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Appropriate Use Criteria
• SPECT MPI (Updated May 2009)
• CCT
• CMR
• TTE/TEE
• Stress Echocardiography
• Coronary Revascularization
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Taking the Quality Platform to the Next Level …
Health Care Reform
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• 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?
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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
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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
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• 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
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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
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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
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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
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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
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Future System Should Reward …
Fee-for-Service + episodes of care Coordination of care Registry Use Adherence to guidelines Measured Performance Improvement
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Where’s the Patient in this Discussion?
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“The best interest of the patient is the only interest to be considered.”
-- William Mayo
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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
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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
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Contact ACC
• ACC Website: www.acc.org
• ACC Phone Number: 800-253-4636