Dear Colleague,

Are you familiar with the  Million Hearts Campaign? As the Million Hearts website explains, "Preventing 1 million heart attacks and strokes in five years will require the work and commitment to change from all of us. There are steps that each of us can take to reach this goal as a nation. Be one in a Million Hearts™ and see how your actions can make a positive difference. A Million Hearts™ begins with you." I hope that you will commit to this important initiative by visiting this link. 

As a health care professional, you play a key role in helping patients reduce their risk for heart disease and stroke and lead longer and healthier lives.

Focus on the "ABCs" with your patients:

• Emphasize that controlling blood pressure and managing cholesterol reduces your patients' risk of heart attack and stroke.
• Ask your patients about what makes it hard for them to take their medications and help them find ways to make it easier.
• Ask your patients about their smoking habits and provide smoking cessation counseling and tools to help current smokers quit.
• Prescribe appropriate aspirin therapy for those who would benefit from it.
• Promote heart-healthy habits to your patients, such as regular physical activity and a diet rich in fresh fruits and vegetables.
• Reduce out-of-pocket costs for smoking cessation, blood pressure and cholesterol medications and services.

Use health information technology and quality improvement tools to:

• Track and improve ABCS performance.
• Report on the ABCS-related Cardiovascular Prevention Measures Group in the CMS Physician Quality Reporting System.
• Use electronic health records with clinical decision support tools and patient registries.

Connect with other health care professionals in your community to improve ABCS in your patients:

• Support team-based approaches to care to improve coordination and quality of care for patients.
• Implement innovative care models (patient-centered medical homes, Accountable Care Organizations) that include a focus on the ABCS.
• Recognize and reward health care providers who address and promote the ABCS in their patients.
• Align provider education and quality improvement initiatives to focus on and improve the ABCS.

Decrease health disparities - use culturally appropriate education materials, patient navigators, community health workers to address barriers to care. Connect at-risk patients with community resources for self-management and resources to address barriers to adherence, addressing any inequities in treatment and diagnosis detected by your registries. 

Some of the existing investments in cardiovascular health that can be leveraged include: 

• Physician Quality Reporting System
• Medicare & Medicaid Electronic Health Records Incentive Programs
• HITECH Act programs (health information resources, health information exchanges, regional extension centers, Beacons)
• Patient Centered Medical Home Initiatives
• Medicare Shared Savings Programs (Accountable Care Organizations)
• CMS Innovation Center Initiatives
• Medicare Quality Improvement Organization (QIO) Program initiatives, including cardiac care learning and action networks and support for provider participation in the Physician Quality Reporting System  

Again, please commit to this important initiative! Feel free to contact me at christopher.cooper@utoledo.edu.

Sincerely,

Christopher J. Cooper MD, FACC

President, Ohio Chapter of the ACC

RUC Surveys Affect You!  Surveys will be distributed this June related to four different code families: EKGs, extracranial duplex studies, transitional care management, and complex chronic care management. If you are randomly selected and receive a survey, please take 10-20 minutes to thoughtfully complete it. Contact James Vavricek at 202-375-6421 or  jvavricek@acc.org if you have questions.

Annual updates to physician work relative values are based on recommendations from a committee involving the AMA and national medical specialty societies-the RUC. The RUC is an expert panel of the AMA and specialty societies charged with developing relative value recommendations to Medicare. A key part of the RUC process is the completion of relative value surveys. Data from these surveys are used to establish the physician work that determines Medicare reimbursement.

There is an excellent review of the "Relative Value Scale Update Committee" process from the American Academy of Family Practice website (see it here).

Under the recently released 2013 Hospital Inpatient Prospective Payment System proposed rule, which covers payment and quality issues for services provided to patients admitted into the hospital, payment rates to hospitals will increase by 2.3 percent. The rule states that the introduction of surgical site infections following cardiac implantable device procedures will be classified as a "hospital-acquired condition" and the hospital will not be eligible for higher payments resulting from the complication in conditions. As part of the Affordable Care Act, the rule establishes penalties for hospitals with high readmission rates for patients with acute myocardial infarction, heart failure and pneumonia. A performance measure for statins prescribed at discharge has also been added as part of the hospital value based payment program that adjusts payment based on the quality of care provided in the hospital setting. Stay tuned for ACC's comments on the proposal after additional analysis is completed.

Under CMS' recent final provider enrollment rule, specialists are exempt from recent changes to provider enrollment standards. The rule calls for providers and suppliers to include their National Provider Identifier (NPI) on all Medicare and Medicaid enrollment applications, but exempts specialists since Medicare beneficiaries are not required to have a referral to see a specialist. Additionally, the rule says that residents can enroll in Medicare in states where they are licensed to practice and order treatments; however, teaching physicians will be required to include an NPI in states where residents are not licensed. To learn more about the changes, click here. Meanwhile, to accommodate the new requirements for tracking NPIs of referring and ordering physicians, the ACC anticipates changes to the CMS-1500 form within the next year. The College is monitoring these developments, but urges providers to consult with their practice management system vendors to ensure systems are up-to-date. Also of important note, the Internet-based PECOS (Provider Enrollment, Chain, and Ownership System) now allows providers to sign Medicare enrollment applications electronically. Once an application is submitted, providers will receive an email from "customerservice-donotreply@cms.hhs.gov" with additional instructions.

New appropriate use criteria (AUC) focused on peripheral vascular ultrasound and physiological testing.   

Learn more.

Interested in applying for an ACC Distinguished Award?

Find out the details.