acc board of governors meeting september 2010 jim fasules, md facc svp advocacy the american college...
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ACC Board of Governors MeetingSeptember 2010
Jim Fasules, MD FACC SVP AdvocacyThe American College of Cardiology
Health Reform et al:Where we are now
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Healthcare Reform: Hollywood on the Potomac
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Reform Started with ARRA
$1.1B for CER (PCOR)
$36B for HITMeaningful use
$44,000 - $66,000 for MDs
Misinformation – “death panels”
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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. ?
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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
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Other BIG issues we face…
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“Reform 2010”: the Rule and the RUC
SPECT MPI cut 36% after ECHO cuts and lower PE
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The “Rule” – Where are we now?
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Cliff Happened!!!!
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RBM Onslaught on “self-referral”
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Critical Issues Lie Ahead
• ACOs and Payment Reform
• Public Reporting
• Maintenance of Certification
• Primary Care - PCMH?
• Physician Employment
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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
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ACC Board of Governors MeetingSeptember 2010
Jack Lewin, M.D., CEOThe American College of Cardiology
Health Reform:What Lies Ahead
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A crack in the crystal ball
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Controlling the future?
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The Bullish Forces
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PPACA
The beginning or result of health reform?
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The pressure for cost containment and fair
competition in a global economy
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The pressure for integration and consolidation
• Physicians, hospitals and insurers• ACOs• Vertical vs. horizontal integration
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The pressure for physician employment
• AMA estimates• ACC estimates• Impacts on professional societies• Vertical vs. horizontal integration
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The pressure to move away from fee-for-service
reimbursement• Payment reforms• PCMH (patient centered medical home)• Government strategy
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The pressure for delivery system reform
• EHRs and Meaningful Use• Care coordination• Prevention and chronic disease
management• H2H, etc.
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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
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The pressure to improve population health
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Risks and Opportunities
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Causes for Cautious Optimism
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PINNACLE and NCDR
FOCUS and AUC
CPIP/CPR
ACC Science, Education, LLL, POC Innovation
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Uniting a fragmented profession
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