ACC chimes in with U.S. healthcare reform recommendations

The American College of Cardiology (ACC) published its vision for U.S. healthcare reform, describing both existing initiatives and plans for the future, and called for cardiologists to play an active role in shaping healthcare reform, in the Aug. 4 issue of the Journal of the American College of Cardiology.

"Under the organizing principle of 'Quality First,' the ACC is encouraging healthcare providers to act on their professional responsibility and transform healthcare from the inside out," wrote the editorial's authors, James T. Dove, MD, and W. Douglas Weaver, MD, both ACC past presidents, along with Jack Lewin, MD, the ACC's CEO.

"We must remain focused, involved, and prepared to lead," the authors wrote. "It is our responsibility to ensure any reforms are practical and appropriate for cardiovascular patients and practices."

The article noted that the death rates from cardiac disease and stroke have plummeted by 60 percent and 70 percent, respectively, over the past 30 years, due to public awareness, new medications, devices and treatment strategies.

However, they wrote that not everyone has access to high-quality healthcare. In fact, more than 46 million Americans have no health insurance, and at least as many are under-insured. In addition, there are wide variations across the country in outcomes, quality and the use of medical resources.

As a result, the authors said that the momentum for healthcare reform is rapidly growing. The ACC has endorsed six principles necessary for healthcare reform, including:
  • Universal coverage;
  • Coverage through an expansion of public and private (pluralistic) programs;
  • Focus on patient value-transparent, high-quality, cost-effective, continuous care;
  • Emphasis on professionalism, the foundation of an effective partnership with empowered patients;
  • Coordination across sources and sites of care; and
  • Payment reforms that reward quality and ensure value.

The ACC also favors payment reform that rewards those who focus on total patient care and prevention, supports team-based care and encourages the appropriate use of tests and procedures.

The college said it has developed a series of action plans to focus on reducing cardiovascular-related hospital readmission rates, limiting inappropriate imaging, reducing geographic variations in care, encouraging adherence to guidelines, partnering on patient-centered medical home models, ensuring transparency and professionalism, testing payment models that reward quality, and increasing prevention of cardiovascular disease.

"We must take responsibility for reducing the high costs that we can control such as those associated with duplication, overuse and a lack of coordination of care," the authors concluded. "We must also address the underuse and failure to adhere to proven medical regimens. We can do better and must become good stewards in the use of healthcare resources."

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