News

FDA Approves SAPIEN Transcatheter Heart Valve
The Food and Drug Administration (FDA) has announced approval of the Edwards Lifesciences SAPIEN Transcatheter Heart Valve. This is one of several devices in development for use in the emerging field of transcatheter aortic valve replacement (TAVR). In announcing the decision, the FDA also noted that Edwards Lifescience will continue to evaluate the outcomes of the SAPIEN transcatheter heart valve through a national Transcatheter Valve Therapy (TVT) Registry that will track patient safety and real world outcomes related to emerging TAVR procedures. The American College of Cardiology and the Society of Thoracic Surgeons have been working with the FDA and the Centers for Medicare and Medicaid Services in the development of this new registry, called the TVT RegistryTM, which is scheduled to launch in late 2011. It will be the first national program to evaluate safety and efficacy of a TAVR option for patients who are otherwise considered to be high-risk or non-operable for conventional valve replacement surgery. For more on the announcement and what this means for TAVR, click here.

2012 Physician Fee Schedule Final Rule Released
The Centers for Medicare and Medicaid Services released the final 2012 Medicare Physician Fee Schedule on Nov. 1.  This final rule, which sets payment levels and other associated policies for next year, includes a number of issues important to cardiology. On a broad scale, the rule cuts payments to cardiologists by an average of 2 percent depending on the mix of services provided. It also includes the mandated 27.4 percent cut in overall Medicare payments as a result of the sustainable growth rate formula, or SGR. This cut will take effect on Jan. 1, 2012without congressional action. Other payment adjustments of note: a 29 percent reduction in payment rates for the replacement of pulse generators on pacemakers and ICDs, as well as a 25 percent reduction in payment rates for the professional component of advanced imaging services  provided by the same physician on the same day. CMS had initially proposed slashing the imaging payment rates by 50 percent, but changes its mind as a result of advocacy efforts by the ACC and others.  Learn more information about the Final Rule, including policy implications relating to e-prescribing and the physician quality reporting system.  A special webinar to discuss the coding changes included in the final rule is scheduled for Nov. 30. Registration is open at CardioSource.org/webinars. In addition, providers can also pre-order the 2012 CPT Reference Guide for Cardiovascular Coding and save 10 percent.

Don’t Ignore RUC Surveys!
Annual updates to the 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. This November, surveys will be distributed related to percutaneous coronary intervention, ablation, and extremity artery/vein ultrasound. If you are randomly selected and receive a survey, please take 15-20 minutes to thoughtfully complete it. Contact James Vavricek at the ACC at 202-375-6421 or jvavricek@acc.org if you have questions or would like to receive a survey.

Final Rule on Accountable Care Organizations (ACOs) Released
CMS recently issued its final rule on ACOs, which make it easier for doctors and hospitals to participate by cutting in half the number of performance measurements, removing the electronic health records requirement and eliminating financial risks for some groups.  Theca supported many facets of the proposed rule that was released earlier this year but expressed concerns that the requirement for ACOs to take on financial risk would make it difficult if not impossible for physicians to form together with hospitals to form an accountable care organization.  While the ACC is supportive of the focus on quality of care and the particular focus on cardiovascular care within the final rule, there must be continued flexibility for physicians and other providers to improve care.

January Deadlines Approaching
As of Jan 1, 2012, suppliers who furnish the technical component of Advanced Diagnostic Imaging (ADI) must be accredited in order to bill Medicare for these services.  For dates of service on or after Jan. 1, MACs will begin denying claims by non- accredited suppliers.  More information about Accreditation process, including a list of accrediting organizations and details of the accreditation process, is available on the CMS website and on CardioSource.org. Also, as of Jan. 2012, providers must be transitioned to Version 5010. There are certain steps that providers should be taking this fall to ensure a smooth transition. Specifically, providers should be continuing with external testing and making any system revisions. Daily transactions, such as claims and eligibility determinations, should be undergoing testing as well. More information on the transition is available on the CMS website and on CardioSource.org.

State Agency takes ACTION for Better Outcomes
The American College of Cardiology Foundation has signed an agreement with Washington State’s Clinical Outcomes Assessment Program (COAP), whose mission is to improve the quality of care for patients with heart disease who receive cardiac interventions, to use the ACTION Registry-GWTG to expand the state’s focus on care coordinate issues. This agreement is the first formal engagement for the ACTION Registry GWTG® working directly for a state agency. Washington state hospitals that perform PCIs already can use their Cath PCI Registry data to meet the COAP data submission requirements. COAP will assist NCDR in disseminating targeted marketing materials to streamline sites enrolling in the registry. Learn more about the ACTION Registry GWTG.

ACC In Touch Blog: Opening Doors for CHD Patients
The lack of continuous care for congenital heart disease (CHD) patients who are transitioning from the pediatric to adult care settings has been a concern for adult cardiology practices. Enhancing collaboration between a coordinated care team, to include congenital heart specialists, and CHD patients would open the doors to consistent and efficient treatment. In an ACC In Touch Blog post, Michael Mansour, MD, FACC, Mississippi governor and member of the Coding Task Force shares what he thinks is the essential information patients should easily be able to provide their cardiologists upon an initial visit, which includesinitial diagnosis, operations chronologically with institution and surgeon, all operative notes and most recent diagnostic studies and results. He points to the ACC’s Adult Congenital and Pediatric Cardiology (ACPC) Section and the NCDR’s IMPACT Registry™ (IMproving Pediatric and Adult Congenital Treatment) as advocates for improved treatment in CHD patients. Read the full blog and look for the Nov./Dec. issue of Cardiology magazine for an article on ACHD.

 

Significant Downward Trend in Hospitalization for Medicare Beneficiaries With HF
Overall heart failure (HF) hospitalization rates among Medicare patients has declined significantly since 1998, with the overall one-year mortality rate also declining slightly over the past decade, according to a new study published in the Journal of the American Medical Association (JAMA). Considered the largest study to date examining trends in HF hospitalization rates across the United States, it showed heart failure hospitalizations dropped nearly 30 percent between 1998 and 2008. The study authors attributed the decline to fewer individual patients being hospitalized with HF rather than a reduction in the frequency of HF hospitalizations. Other findings included: black men had the lowest rate of decline for HF hospitalization among those studied; despite the decline over the past decade the one-year mortality rate remains high – 31.7 percent in 1999 and 29.6 percent in 2008; one-year mortality rates declined significantly in four states but increased in five states. This study comes on the heels of a paper published earlier this year showing significant improvements in D2B times. To learn more about this study and to access a link to the full article, read the CardioSource journal scan.

NCDR® Debuts New Cath PCI Registry® Dashboard
The CathPCI Registry Dashboard provides users with a new look for viewing their quarterly outcomes reports and enhanced functionality that allows them to drill down, create unique comparison groups and identify gaps in care – all designed to help improve patient care. The Dashboard gives cardiologists, administrators and health care professionals another tool they can use to meet the coming demands of value-based purchasing and increased public transparency. The NCDR expects to release the Dashboard functionality for its other registries in the near future. Learn more about NCDR and the new CathPCI Dashboard.

American College of Cardiology Launches PINNACLE-AF
The American College of Cardiology (ACC) is expanding the PINNACLE Registry, with a new platform focusing on atrial fibrillation and including the next generation of anticoagulants. The new platform, PINNACLE-AF, will operate within the existing PINNACLE Registry, the largest cardiovascular outpatient database in the U.S., and part of the ACC’s National Cardiovascular Data Registry (NCDR). NCDR is the most comprehensive, outcomes-based cardiovascular patient data registry for quality improvement in the United States. PINNACLE currently has 2.1 million patient records representing valid patient encounters from hundreds of outpatient practices nationwide. Of those patients, over 100,000 have atrial fibrillation. Participation in the Registry is free to all cardiology practices. For more information about the PINNACLE Registry and PINNACLE-AF, visit www.PINNACLEregistry.org.

PINNACLE Network/Paragon Health Webinar Series to Focus on Advancing the Business of CV Care
The ACC’s PINNACLE Network is partnering with Paragon Health to present a six-part webinar series focused on "Advancing the Business of Cardiovascular Care." The webinars, all of which will take place from 4-5 p.m. (ET), are free to ACC members and will feature key health care and/or physician leaders addressing hot topics related to the evolving models of cardiovascular practice. The final two webinars on Nov. 8 and Nov. 29 will focus on optimizing revenue cycle management and aligning incentives through co-management models, respectively. Archives of the four earlier webinars are also available. Learn more at CardioSource.org/PINNACLE Network.

November ACC Update Looks at TAVR, Mended Hearts and More!
The November ACC Update video looks at a new program founded by an ACC member that helps patients live a better heart healthy lifestyle and the landmark summit on non-communicable diseases held recently in New York and attended by ACC leaders including president-elect William Zoghbi.  The update also highlights a new industry training program for medical and device representatives to learn more about cardiovascular care.  There is also an interview with ACC senior vice president Kevin Fitzpatrick who discusses the collaboration between the College and the patient-centered organization, Mended Hearts. Watch the video.

ACC Submits Comments on Proposed 2012 Medicare Physician Fee Schedule
The ACC submitted formal comments to the Centers for Medicare and Medicaid Services on its proposed 2012 Medicare Physician Fee Schedule. The letter addresses coding of certain services; expansion of the multiple procedure payment reduction policy; physician quality reporting (including future payment adjustments under the Physician Quality Reporting System); Maintenance of Certification program incentives; e-prescribing; and the Physician Compare website. Read the full letter. The final rule is expected in late October.

VIDEO: October ACC Update Looks at Reduced D2B Times, Payment Innovations and More
The latest edition of ACC Update focuses on the stunning improvements in door-to-balloon (D2B) times for patients undergoing percutaneous coronary intervention following an acute myocardial infarction. In addition, ACC CEO Jack Lewin, MD, and health care economist Len Nichols, PhD, discuss payment innovations in health care, including the ACC’s new Community on Payment Innovation led by Nichols. The video also looks at the future of lifelong learning and membership opportunities. Watch the complete video.

New Online Community Focuses on Payment Innovations
The American College of Cardiology (ACC) and the American Journal of Managed Care (AJMC) have launched a new online “Community on Payment Innovations,” funded by Johnson & Johnson, with the goal of bringing together a unique combination of key stakeholders to advance the payment reform debate, encourage innovation and collaboration, and share best practices and lessons learned. This group, led by health care economist Len Nichols, PhD, will discuss new and innovative payment models to improve the health care system by bending the cost curve, with the Patient Protection and Affordable Care Act as the backdrop. The cardiovascular community, physicians, providers, practice administrators, health policy professionals, health care economists, federal and state governments, early innovators, payers and other health care stakeholders are encouraged to participate in the discussions.

Cardiologists on the EMR incentive uptake
Fifty-five percent of cardiologists who responded to an American College of Cardiology (ACC) survey are either participating or plan to participate in the Centers for Medicare and Medicaid Services’ (CMS) Electronich Heatlh Record (EHR) Incentive Program. Thirty-four percent have already registered, according to the survey published in the College’s Cardiology magazine. CMS reported that in July, cardiology was the third highest specialty to participate in EHRs. The ACC's July survey of a 152 randomly selected panel of members found that 34 percent of participants reported that they have registered for the EHR Incentive Program, and about half of that group—18 percent of total respondents—have met the requirements for the program and have attested to doing so. Read more about this topic in Cardiovascular Business and in Cardiology magazine.

HHS Approves Plan to Screen All Newborns for Congenital Heart Defects
U.S. Department of Health and Human Services Secretary (HHS) Secretary Kathleen Sebelius approved the Secretary's Advisory Committee for Heritable Disorders in Newborns and Children recommendation to add a screening for critical congenital heart defects to the recommended universal screening panel. This means that all children born in the U.S. will be screened for congenital heart defects within the first 48 hours of life using pulse oximetry. The American College of Cardiology, along with other members of the congenital heart disease community, played an important role in making this a reality.

ACC IN TOUCH BLOG: Next Steps for Reducing PAD Prevalence
The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) released updated guidelines for the diagnosis and management of peripheral artery disease (PAD). The updated document provides agreed-upon approaches and treatments for PAD that clinicians can apply to help improve patient care. The guidelines include expanded criteria for using the ankle-brachial index (ABI) for earlier diagnosis; increased efforts to ensure all patients have access to smoking cessation services, improved use of clot-preventing medications, as well as a more focused definition of effective interventions for avoiding limb amputations and treating aortic aneurysms. In an ACC In Touch blog post, Thom Rooke, MD, FACC, and Alan T. Hirsch, MD, FACC, chair and vice chair of the PAD Guidelines Writing Committee, respectively, called the guidelines a road map to greater prevention opportunities, which will be necessary if we are to reduce the number of people needlessly affected by PAD. Read more on the ACC In Touch blog.

PINNACLE Network/Paragon Health Webinar Series to Focus on Advancing the Business of CV Care
The ACC’s PINNACLE Network is partnering with Paragon Health to present a six-part webinar series focused on "Advancing the Business of Cardiovascular Care." The webinars, all of which will take place from 4-5 p.m. (ET), are free to ACC members and feature key health care and/or physician leaders addressing hot topics related to the evolving models of cardiovascular practice. Registration is open for the three remaining webinars. In addition, archives of the previous webinars are also available. Register today at CardioSource.org/Webinars!

• Cardiovascular Service Line: Building a Foundation for Success - Understand the key elements for achieving alignment across the hospital and practice to bridge siloes and transform from a product line to a CV enterprise. (Oct. 18)
• Private Practice Success Strategies: How to Optimize Revenue Cycle Management - Focus on the best practices necessary for developing a meaningful revenue cycle management function within physician practices and learn what common pitfalls to avoid. (Nov. 8)
• Aligning Incentives Through Co-Management Models - Understand the key elements of clinical co-management structures through case study presentations and expert commentary. (Nov. 29)

Early Bird Registration is Now Open for ACC.12
The American College of Cardiology’s 61st Annual Scientific Session & Expo reflects the College’s passion for science, education and peer-to-peer networking. ACC.12 in Chicago will highlight the ACC’s focus on lifelong learning and practice improvement, and will feature a new learning pathway structure to better address the needs of cardiovascular professionals round the globe. New this year: ACC.12 will officially kick off with the opening session at 8 a.m. on Saturday, March 24, and will close on Tuesday, March 27, at noon with a brand new ACC.12 Innovators session featuring the top leaders in cardiology. Register by November 8 for special early bird registration rates and the best availability of hotels. For more information visit www.accscientificsession.org.

New Spanish Language Patient Education Video on Cardiac Rehab
In collaboration with CardioSmart, the Coalition to Reduce Disparities in Cardiovascular Outcomes (credo) has released a Spanish-language patient education video extolling the benefits of cardiac rehabilitation. Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, the National Alliance for Hispanic Health, the National Hispanic Cardiology Leadership Network and the Preventive Cardiovascular Nursing Association, the video highlights barriers to enrollment and completion of cardiac rehab and how patients overcome such barriers through vignettes of three cardiac rehabilitation program enrollees. Email credo@acc.org to request a free DVD copy.

New Study Using NCDR Data Looks at Appropriate Use of PCI
A new study based on NCDR® data titled “Appropriateness of Percutaneous Coronary Intervention (PCI),” shows that although the majority of patients are appropriately selected for PCI procedures, there are opportunities for improvement, especially in the non-emergency setting. Published in the Journal of the American Medical Association, researchers useddata from the CathPCI Registry® the vast majority of PCIs performed in acute settings (98.6 percent) were classified as appropriate. For non-acute indications, however, 11.6 percent were classified as inappropriate, with substantial variation noted across hospitals. Studies like these are extremely beneficial to patients and to the entire field of medicine. They highlight the important role registries can play in identifying opportunities for individual hospitals and practices to monitor their performance and adopt or develop quality improvement initiatives to optimize the care they deliver. For more information on the study, click here. You can also learn more about the College's ongoing efforts related to appropriate use of PCI and other therapies and procedures in the "Appropriate Use" issue center on CardioSource.org.

ACC Testifies at FDA Advisory Committee Hearing on SAPIEN Transcatheter Heart Valve
American College of Cardiology (ACC) President David Holmes, Jr, MD, FACC, represented the College at an FDA Advisory Committee meeting in July regarding pre-market approval of Edwards Lifesciences SAPIEN Transcatheter Heart Valve. Leaders from the Society for Thoracic Surgery (STS) and the Society for Cardiovascular Angiography and Interventions (SCAI) also spoke. The ACC is working closely with STS, SCAI and others to align efforts to ensure the physician community is prepared to appropriately use this new technology and techniques. The panel voted on three main questions following the hearing, in general agreeing to recommend approval of the device. The panel – for the first time ever – also recommended that Edwards be required to have all users of the device participate in a professional society registry like NCDR®. The next step is FDA approval. The ACC has posted a detailed summary in the FDA Issues center on CardioSource.org that includes links to the official statements, more information on the specific committee questions, and background information on the PARTNER trial and ACC/STS efforts related to TVT. A video with Holmes and STS President Michael Mack, MD, FACC, is also available.

FDA Approves Ticagrelor
The Food and Drug Administration has approved the anti-platelet drug ticagrelor for patients with acute coronary syndromes (ACS). A boxed warning to health care professionals and patients warns that aspirin doses above 100 milligrams per day decrease the effectiveness of the medication. It also notes that, like other anti-platelet agents, ticagrelor increases the rate of bleeding and can cause significant, sometimes fatal, bleeding. The ACC will be working with the American Heart Association and Heart Rhythm Society to incorporate ticagrelor into future guidelines. Learn more about the decision.

Call for Innovative Payment Models!
The ACC, in partnership with the American Journal of Managed Care (AJMC) and with sponsorship from Johnson & Johnson, is creating a first-of-its-kind "Community on Payment Innovations" with the goal of providing an interactive, online venue where cardiovascular professionals and others can engage in meaningful dialogue to advance current and innovative payment models. The community will feature, among other things, case studies, videos, webinars and hot topic discussions. While an editorial panel of experts is already in place and developing venerable content and identifying discussion topics, the College is also seeking expert advice from members currently involved with testing and/or implementing new payment models. The goal is to use these "case studies" as the basis for discussion when the community launches in September. Submissions should be sent to advocate@acc.org with "Payment Models" in the subject line.

Registration Deadline Extended: Don’t Miss the 2011 Legislative Conference!
The registration deadline for this year’s Legislative Conference taking place Sept. 11-13 in Washington, DC, has been extended to August 14. The agenda is shaping up to include key congressional members, their staff and health policy leaders speaking to hot topics like health reform implementation, payment innovation and regulatory trends. General Stanley McChrystal also will address participants on the subject of leadership during the Sunday night's dinner to benefit the ACC Political Action Committee (PAC). Tickets are required for the dinner. General admission is $250 per person ($50 for FITs, CCAs and Practice Administrators). VIP admission, which includes preferred seating and a meet-and-greet reception with the general prior to the dinner, is $1,000 per person ($250 for FITs, CCAs and Practice Administrators). As always, participants will head to Capitol Hill on Tuesday to meet directly with their congressional delegation. More information is available at CardioSource.org/LegislativeConference.

Read the July/August Issue of Cardiology
The latest issue of Cardiology magazine has arrived! Don’t miss great articles on medication adherence, sleep apnea and the latest NCDR research. In addition, the magazine includes a feature on the Puerto Rico Chapter’s efforts to engage FITs and patients, as well as an overview of the state-level advocacy issues facing chapters across the country. Read the latest issue at CardioSource.org/CardiologyMagazine. Also look for extended coverage on credo and breaking news items throughout the month of August. In addition, the Cardiology online site includes a special discussion forum and options to download the new Cardiology app for your iPad or iPhone.

PINNACLE Network/Paragon Health Webinar Series to Focus on Advancing the Business of CV Care
The ACC’s PINNACLE Network is partnering with Paragon Health to present a six-part webinar series focused on "Advancing the Business of Cardiovascular Care." The webinars, all of which will take place from 4-5 p.m. (ET), are free to ACC members and will feature key health care and/or physician leaders addressing hot topics related to the evolving models of cardiovascular practice. Whether you are staying in private practice, or are fully or partially integrated with a hospital system, this series is for you. Register today at CardioSource.org/Webinars!

• Physician-Hospital Alignment: The Fundamentals of Integration - Learn about current integration models and trends and hear from experts on the elements necessary for a successful integration. (Sept. 7)
• Integration is not Alignment: Constructing Sustainable Models - Hear from experts on the common obstacles to sustaining integration and alignment and gain insight into best practices. (Sept. 22)
• Effective Governance: Best Practices in Decision Making - Learn more about the basic tenets of sound practice in both private and integrated settings and hear from leaders on the challenges and best practices associated with transitioning from private to integrated models. (Oct. 4)
• Cardiovascular Service Line: Building a Foundation for Success - Understand the key elements for achieving alignment across the hospital and practice to bridge silos and transform from a product line to a CV enterprise. (Oct. 18)
• Private Practice Success Strategies: How to Optimize Revenue Cycle Management - Focus on the best practices necessary for developing a meaningful revenue cycle management function within physician practices and learn what common pitfalls to avoid. (Nov. 8)
• Aligning Incentives Through Co-Management Models - Understand the key elements of clinical co-management structures through case study presentations and expert commentary. (Nov. 29)

Prepare for Jan. 1 HIPAA compliance with new AMA toolkit
If physician practices or vendors submit claims electronically, they must adhere to the Jan. 1, 2012 compliance deadline for using Version 5010 of the HIPAA electronic standard transactions. Noncompliance puts physician practices at risk for rejected claims and cash flow interruptions. Learn the steps needed to comply with the new 5010 toolkit from the American Medical Association (AMA). The toolkit explains the differences in Version 5010, how to test readiness for the Version 5010 transactions, and steps to take to prevent interruptions to cash flow. Access the toolkit and additional resources. Also visit the “Coding and Billing” section of CardioSource.org/Practice-Management for ACC resources on this issue.

Introducing the newest Meeting on Demand ™ Program: Recent Advances in Clinical Nuclear Cardiology and Cardiac CT
Physicians can now explore the “Recent Advances in Clinical Nuclear Cardiology and Cardiac CT” live program anytime with the ACC’s most recent Meeting on Demand™ Program. The program will survey the various imaging modalities and cutting edge technologies and offer healthcare professionals the opportunity to listen to lectures from the experts with slides synched to audio covering developments in the field.

ICACTL Hosts Webinar Accreditation Series
The Intersocietal Commission for the Accreditation of Computed Tomography Laboratories (ICACTL) is hosting two free webinars on August 16 on accreditation and the ICACTL process. The webinars will focus on the key elements of submitting a successful application for accreditation. Mary Lally, MS, RT(R) (MR), IAC Director of Accreditation-MR/CT/Carotid Stenting will discuss the website, online application and the most common reasons for delayed accreditation. A live question and answer session at the end of the presentation will be available. The American College of Cardiology (ACC) is a sponsoring organization.
Register for the August 16 webinar at 10:30 a.m. ET
Register for the August 16 webinar at 5 p.m. ET

Find best practices for appropriate use of imaging in the FOCUS Innovation Community
The FOCUS Innovation Community provides an online forum for members to exchange ideas and experiences on the appropriate use of cardiac imaging. This online environment complements the FOCUS performance improvement module and offers educational and networking opportunities for those interested in appropriate use criteria. Join the FOCUS Innovation Community.