News | Published: Friday, February 2, 2024 2:00 am
The American College of Cardiology (ACC) Cardiovascular Summit 2024 in Washington, DC, kicked off with educational sessions focused on how business leaders in cardiology can improve patient access to care and the future outlook for cardiovascular services.
The pre-conference session, “Building Your Foundation for the Cardiovascular Summit,” summarized the challenges facing clinicians, administrators and business leaders in the current healthcare environment. Varying levels of complexity of payment plans, Medicare reimbursement considerations, a large population of baby boomers presenting with cardiovascular events, and high rates of mortality and morbity for female patients in the U.S. impact care delivery and patient outcomes. “Delivering cardiovascular care is a team sport. We need our team,” emphasized Cathleen Biga, MSN, FACC, incoming ACC president and pre-conference faculty member.
The faculty discussed the importance of dyad leadership to make informed decisions based on the experiences of individual care team members. Top institutions in the U.S. utilize dyad leadership consisting of strong and engaged physician leaders and administrative leaders to guide the cardiovascular service line. Nurses also need to be at the table to inform leadership decisions. This inclusive leadership model then drives accountability, authority and standardized processes by monitoring compensation, reimbursement and productivity. “Evidence is in the success of a service line,” said Biga. Faculty also strongly recommended that dyad leadership should be integrated into ambulatory strategies and trickle down to cath labs, noninvasive imaging and cardiac rehab.
Harold D. Miller, MS, introduced his plenary session, “What Will CV Services Look Like in 2030? Two Different Paths to the Future,” by considering the evolution of dyad leadership from past models of cardiovascular care. One path to the future of cardiovascular care in the U.S. is an extension of the current iteration of value-based care. Currently, too much spending on healthcare results from the money flowing through insurance plans. This makes care more expensive for patients and prevents those patients from accessing the care they need. On this path, the largest share goes to hospital systems, a small portion goes to specialists and the smallest portion goes to primary care providers. To reduce spending, the hospital systems reduce costs by cutting specialists like cardiologists.
While this iteration of value-based care is not designed to benefit patients, patients need to become the primary priority. Miller challenged attendees: “Take charge and create a clinician-driven and patient-centered delivery system.” Miller advocated for a value-based care model in which clinicians are adequately compensated to deliver safe and effective procedural care, generating profit for all constituents. In this model, payments would be based on clinicians delivering evidence-based care rather than rewarding complications or additional office visits with increased profit.
Miller considered opportunities for increasing models by shifting payments away from procedure numbers and patient visits to creating efficiencies by giving hospitals a standby capacity payment in emergency care based on the number in the community who would benefit from the services, not the number having an event. Miller also encouraged attendees to contemplate opportunities that would save at all different phases of care (diagnosis, planning, initial treatment, continued care for condition, etc.), utilizing different providers at each phase to separate payments.
Both sessions emphasized how dyad leadership, optimizing the care team and considering the payments needed to support clinicians and their patients can create a foundation for optimal outcomes.
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