ACC Goals 2006: An Overview - Advocacy, Education and Quality Priorities

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ACC Goals 2006 An Overview - Advocacy,
Education and Quality Priorities

• Gerald V. Naccarelli, MD, FACC

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ACC, The Recognized Leader

• ACC.06
• Banner year for great science! Over 30 late
  breaking trials!
• Over 29,000 attendees!
• Even greater things planned for ACC07!
• i2 Summit
• Exceeded all targets! Over 4,000 attendees!
• 92 of board certified interventional
  cardiologists are FACC
• ACC dedicated to meeting interventional members
  interests

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Turning CV Knowledge into Practice through..

• Innovative Educational Opportunities
• ACC07 and i2 Summit in
• New Orleans!
• JACC
• Cardiosource a free member benefit
• Educational products
• Educational programs, live, online, and some in
  collaboration with Chapters, such as Diabetes
  Education Initiative

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Turning CV Knowledge into Practice through..

• Development of clinical standards
• ACC/AHA Guidelines
• Competency Training Standards
• ACC/AHA Performance Measures and Data Standards
• Appropriateness criteria

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Turning CV Knowledge into Practice through..

• Improving cardiovascular care and practice
• Electronic Health Records
• NCDR expansion into outpatient and longitudinal
  settings
• Awareness of approved ethical standards
• Disseminating tools and best practices
• ACC-NCDR (CathPCI, ICD, Peripheral
  Interventions)
• GAP
• Chapter-driven local quality initiatives

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Improving Member Satisfaction

• Promoting new leadership from among involved
  members
• Enhancing member communications (Cardiology, My
  ACC, etc.)
• Supporting Chapters
• Collaborating with national and international
  cardiovascular societies
• Improving strategies to reduce industry
  dependence

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Cardiology CommunitiesA Member ValueCardiac
Care Associates

• In 2004, Cardiac Care Associates included in ACC
  membership
• By 2006, over 2,240 CCAs are ACC members
• CCA liaisons in each State addressing local
  needs a CCA liaison is being added to the
  national Board of Governors
• Chapters embracing CCAs in their membership
• ACC now able to offer CE credit to CCAs
• ACC working to identify and document best
  practices of cardiac care teams

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Advocacy 2006 Priorities

• Ensuring Appropriate Medicare Reimbursement
• Preserving Office-Based Imaging
• Promoting Quality Through ACC Initiatives
• Medical liability reform

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Advocacy Physician Fee Formula Fix

• Physician Fee fix
• 4.4 cut stopped for 2006 freeze enacted for
  one year
• 4.7 cut still slated for 2007, and cuts
  totaling 25 over next 6 years
• ACC will work with House of Medicine to revise
  the flawed physician payment formula

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Advocacy Medicare Fee Schedule-Changes

• Five year review of RBRVS
• CMS will publish proposed rule for five year
  review changes this spring
• RUC reviewed work RVUs for 13 cardiology
  procedures. Small decreases recommended for two
  procedures, but no major changes anticipated
• RUC recommended significant changes to work RVUs
  for EM services
• If CMS adopts those changes, there could be a
  significant impact on other services

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Advocacy Medicare Fee Schedule-Changes

• Practice expense
• CMS has released four possible methods for
  restructuring the practice expense component of
  the RBRVS.
• All four project losses in overall payments to
  cardiology, with both cut and increases for many
  cardiology procedures.
• No official proposal has been made yet.

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Advocacy Office-Based Imaging
ACC founded and worked through the Coalition for
Patient-Centered Imaging (CPCI) in 2005 to
preserve office-based imaging policy. CPCI has
successfully

• Detracted efforts to eliminate Stark exemption
• Defeated state-level initiatives
• Influenced private payer policies

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Advocacy Imaging/ Federal

• Onerous imaging cuts included in budget
  reconciliation bill of 2006
• - Effective January 1, 2007, TC payments
  in physician fee schedule are not allowed to
  exceed the HOPD payment rate
• - 2.8 billion cut the first year, 8.7
  billion over 10 years
• - Cardiology cuts over 150 million,
  mostly in echo color doppler flow, nuclear and
  MR
• ACC Letter to Congress outlining 2006 priorities,
  including fighting the cuts
• Participating in broad coalition of other
  providers (including ACR and many CPCI
  organizations) and manufacturers to mitigate the
  cuts

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State Legislation

• California
• Carryover Bills (AB 516 and AB 1572) Die
• AB 2805 A New Wrinkle
• Idaho 
• Imaging Moratorium Legislation Not Offered
• Massachusetts
• HB 2711 the Threat Continues 
• SB 741 and HB.2716 -- Hearings and No Action
• Rhode Island
• SB 2358 and HB 7617 Equal Treatment for MR and
  CT
• Washington
• Olympia Day and the Demise of HB 2310

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Pa - State Legislation

• The Pa legislature convened in January and will
  remain in session until November 30.
• HB 2443 pertaining to continuation of
  demonstration projects for PCI passed the house
  185-10 in a form opposed by the Pa ACC. However,
  the Senate Public Health and Welfare Committee
  approved an amended version on April 3 which
  provides for consultation with the Pa ACC
• HB 1774, a self-referral bill, remains inactive
  in the health and Human Services Committee.

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Advocacy Imaging/Payer

• Educating private and public payers on the
  Colleges available resources for diagnostic
  imaging
• Reimbursement of Cardiac CTA
• Creation of Model LCD for CCTA/CCT
• Final LCDs - 7 Carriers (13 states)
• Draft LCDs 4 Carriers (17 states)
• ACC/ACR CPT Category III Code Valuation
  Recommendations sent to Carrier medical directors
• Private Payer Outreach

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Advocacy Imaging/Payer

• Local collaborations between health plan and ACC
  chapters to influence coverage policies and
  programs
• Highmark (PaACC)
• Blue Cross of Idaho
• Medical Directors Track at ACC.06
• Creating new dialogue and opportunities for ACC
  leadership to interact with health plan and
  Medicare carrier medical directors
• Discussions with United Healthcare regarding
  mandatory diagnostic laboratory accreditation,
  nationwide
• Meeting with Aetna to address its new Color Flow
  Doppler Echocardiography Policy
• Establishing relationships with
  employers/purchasers National Business Group on
  Health and National Business Coalition on
  Healthcare.

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Advocacy Promoting Quality Initiatives

• Value-Based Purchasing
• ACC is joined with the House of Medicine to
  advocate for the application of fair value-based
  purchasing principles that primarily work to
  improve care

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Advocacy Promoting Quality Initiatives

• Value-Based Purchasing
• Medicare Physician Voluntary Reporting Program
• Discussions with CMS on relevant cardiovascular
  measures
• Education to members on impact of program
• Assessing ACCs quality programs as tools
• Chronic Care Improvement Program Pilots
• Joint effort with national and local ACC chapters
  in MD, PA, IL to pilot disease management programs

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Advocacy Promoting Quality Initiatives

• Value-Based Purchasing
• MDI 2005 Barriers to Implementation
• Developed solutions to address barriers IT,
  Attribution, Data Collection, Subspecialties and
  Recognition
• Delivered ACCs First Set of Ambulatory Care
  Performance Measures and Appropriateness Criteria
• Identified pilot programs to test quality of
  care, accountability, attribution

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Advocacy Medical Liability Reform

• ACC will continue to work with Doctors for
  Medical Liability Reform to educate public about
  reform
• Press for a Senate vote
• Premiums are rising to crisis levels in at least
  20 states

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• ACC CAN Members to Date
• 262
• In 2005, ACC Members contacted their
• Members of Congress
• 4628 times by email
• 631 times by fax
• 97 times by letter

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• Federal PAC
• Number of PAC Contributors 1551
• Receipt Totals 500,627.09
• PAC Disbursement Totals 142,736.60
• Non-Federal PAC
• Number of PAC Contributors 296
• Receipt Totals 103,623.00
• Total PAC Funds Raised in 2005 604,250.09

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How You Can Help

• Actively support your Chapter
• Respond to calls for action
• Attend the September ACC Legislative Conference,
  Sept. 17-19
• Participate in community events and media
  requests
• Contribute to the ACC PAC and join the CAN
  grassroots network

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Heart House D.C. National headquarters moving
to D.C. for greater visibility and increased
political strength 2400 N Street, NW Opening
Fall, 2006!
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