 The Ohio-ACC was recognized at the ACC Leadership Conference in Washington as the 2011 recipient of the James T. Dove Chapter Recognition Award for Quality. This award is presented to chapters who develop local and regional programs to improve quality of care in their state. Ohio received the award for organizing, in partnership with the Ohio Thoracic and Cardiovascular Data Management Group, a hands-on NCDR CathPCI workshop on May 14, 2010, in Columbus. This conference attracted 72 participants from Ohio, Kentucky, Michigan, and Wisconsin. Participants gained understanding and confidence of data definitions and entry based on actual clinical examples from personal experiences.
ACC Legislative Priorities
Also during the ACC Leadership Conference, the top legislative priorities were discussed:
- ACA amendments: promote tort reform, eliminate or revise the Independent Payment Advisory Board, develop Accountable Care Organizations, and support healthcare exchanges.
- Payment reform issues: develop model programs to explore bundling, gain sharing, global budgeting, registries, and quality measures.
- Private practice protection: oppose radiology benefit managers, advocate for fairness in CMS rule, and eliminate the SGR.
- State advocacy: help develop Medicaid programs and healthcare exchanges.
- Health information technology and meaningful use criteria advocacy.
- Promote innovation and science in cardiovascular therapies.
What's Happening in Washington?
The ACA healthcare bill will not be repealed. Although the House of Representatives voted to repeal the bill, the Senate voted along party lines to defeat the repeal. Likely, certain provisions the healthcare bill will be amended by bipartisan compromise in Congress. Already the1099 form requirement for expenditures over $600 has been repealed and more amendments will follow. However, ACA may still be in jeopardy based on the Supreme Court's decision as to whether Congress has the constitutional authority to mandate that all Americans purchase health insurance. A close vote is predicted.
In his State of the Union Address, President Obama pledged to hold government spending flat for the next five years. This is bad news for the SGR fix, which would require over $250 billion to correct the flawed payment system.
Physician Reimbursement
We heard a recurrent theme in Washington from every sector: Cut physician reimbursement for healthcare services. Netherlands, Ireland, Spain, and other European Union countries are slashing physicians' payments by over 30% to hold down their healthcare expenditures.
The fee-for-service reimbursement system is in trouble. Bundled payments and global population-based payment strategies are predicted to replace the current system.
In the State of the Union Address, President Obama promoted tort reform initiatives although privately he does not support caps on non-economic damages.
HR5
Phil Gingery, M.D. (R-GA), recently introduced HR5, "The Help, Efficient, Accessible, Low-Cost, Timely Healthcare (HEALTH") Act of 2011. This legislation proposes numerous tort reforms to help repair the medical liability system in the US. The bill would help reduce healthcare costs, provide just compensation for medical negligence, promote speedier resolution of disputes, maintain access to the courts, provide unlimited compensation for economic damages, and a cap on non-economic damages. More than a hundred medical societies including the American College of Cardiology, the Ohio State Medical Association, and the Academy of Medicine of Cleveland and Northern Ohio endorse this legislative proposal.
2011 Imperatives
Some cardiology imperatives that I see for 2011 include:
- Develop lifelong learning and certification programs. Likely, the ABIM and specialty recertification exams will remain in place for the foreseeable future.
- Ensure that registry data guidelines and performance measures are valuable and accessible, for point of care information.
- Promote healthcare delivery system innovations.
- Improve patient education. Construct and implement tools for self care and home care.
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Cost of CV Care
 Nancy Brown, MD, CEO, of the American Heart Association, recently discussed the future of cardiovascular care. The complete policy paper can be found in the January 24, 2011, issue of Circulation entitled Forecasting the Future of Cardiovascular Disease in the United States Here are some of the projections for the next three decades: - By 2030, more than 40% of U.S. adults will have one or more cardiovascular diseases. In the next 20 years, the prevalence of cardiovascular disease will increase by 10%.
- The direct costs of cardiovascular diseases will triple from $272.5 billion to $818.5 billion.
- Coronary artery disease and heart failure will increase by 200% during the next 20 years.
- Cardiovascular disease currently is the leading cause of medical bankruptcy in the U.S.
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Avoid the E-Prescribing Penalty
 Starting in 2012, health care providers will be penalized if they do not successfully participate in the federal e-prescribing program. If you think you have until 2012 to avoid the penalty, think again! Despite protests from the ACC, the AMA and other physician organizations, CMS will use e-prescribing data from January through June 2011 to determine whose payments will be reduced in 2012. In short, this means that if you have not begun to report on the 2011 e-prescribing requirements by the end of June 2011, you will see all of your 2012 Medicare payments reduced by one percent. Get the details and avoid the penalty! |
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Is Your Hospital Enrolled in H2H?
CMS has reported that more than 20% of Medicare patients are readmitted to the hospital within 30 days after discharge. Readmission rates for heart failure and acute MI are published for individual hospitals on the CMS web site, www.hospitalcompare.hhs.gov. Medicare officials believe that excessive readmissions increase health care costs and represent a systems failure in health care. The Affordable Health Care Act addresses this issue (section 3025). CMS will impose penalties on hospitals with excess readmission rates starting in 2013.
The H2H initiative is a collaborative effort by the American College of Cardiology and the Institute for Health Care Improvement (IHI) launched in 2009 that now includes more than 1600 individual members. Its goal is to reduce 30-day all-cause readmission rates for heart failure and acute MI by 20% by December 2012.
This initiative is a web-based coalition of hospitals and health care providers that share resources and best practices in order to learn from each other's experience. The H2H consists of a web site, webinars, a list serve, and a bulletin board.
Prevention of 30-day readmissions utilizes three components:
1. Medication management: Patients need to purchase medications, know them, and take them.
2. Early follow up: A visit within one week, preceded by a reminder telephone call, with transportation provided if necessary.
3. Symptom management: Patients are taught to recognize signs and symptoms of heart failure, learn self-care, and understand who and when to call.
Because 30-day readmissions will impact on hospital reimbursement for Medicare patients, it is important to join this coalition. In most cases, the initiative is run by nurses in cooperation with physicians and hospitals. Please log on to join www.h2hquality.org.
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Upcoming Events
Cardiology Coding Seminars
Offered on Feb. 22, 23, or 24, 2011
Cleveland, Columbus, or Cincinnati, OH
Advances in the Management of Atrial Fibrillation
March 15, 2011
Cincinnati, OH
Ohio-ACC Spring Summit
April 13, 2011
Cleveland, OH
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Quick Links
 
614.859.2223
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