American College of Cardiology Quality First SmartBrief

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December 11, 2012

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Transforming Health Care from the Inside Out

First Focus

Cleveland Clinic keeps focus on costs, quality
Doctors at Cleveland Clinic are salaried and on one-year contracts, and they undergo professional reviews each year in an effort to reward quality over quantity, says CEO Delos Cosgrove, whose contract also is renewed annually. The hospital reorganized into institutes focused on disease area instead of separate departments for surgery, medicine and pediatrics. Outcomes and costs are measured and reported, and doctors are aware of how much supplies cost. Business Insider (12/5)

Strong growth of ACOs expected in 2013
Experts predict a rapid increase in the number of accountable care organizations in 2013. "This is becoming a more pervasive phenomenon," said Dr. Norman Chenven of the Austin Regional Clinic. As many as 31 million patients are involved in some way with the ACO model, according to consulting organization Oliver Wyman. American Medical News (free content) (12/10)

Nurse-led phone support cuts readmissions, reduces costs in study
Coordinated transitional care, an intervention where nurses meet with high-risk patients before discharge and call them 48 to 72 hours afterward, resulted in reduced readmission rates and saved about $1,225 per case at a Wisconsin hospital, according to a study in the journal Health Affairs. "This model requires a relatively small amount of resources to operate and may represent a viable alternative for hospitals seeking to offer improved transitional care as encouraged by the Affordable Care Act," lead author Amy Kind said. Nurse.com (12/9)

Other News

Emory CEO: Creating a quality, safety culture is key to improvement
The Atlanta Journal-Constitution (12/8)

Practice Management

Study supports shorter clinical rotations in hospitals
Two-week and four-week clinical rotations led to similar rates of patient revisits after hospital discharge, but the shorter rotations could reduce stress and burnout for attending physicians who teach students, Chicago researchers reported in JAMA. Dr. Brian Lucas said education leaders find short rotations are disruptive and "truncate student-teacher relationships" but if they lower stress for attending physicians it could improve relationships with patients and care quality. Medscape (free registration) (12/5)

Shift away from independent doctors continues
The population of independent doctors in the U.S. declined from 57% in 2000 to 39% this year, an Accenture survey of 204 doctors found. Most of the respondents said costs tied to running an independent practice made them consider looking for an employer. DoctorsLounge.com/HealthDay News (12/10)

E-Health Watch

Study finds increased use of basic EHRs among office-based doctors
A survey by the CDC's National Center for Health Statistics found that 39.6% of office-based doctors used basic EHR systems in 2012, up from 33.9% in 2011. Wisconsin had the highest share of doctors who use basic EHRs, followed by Minnesota, North Dakota and Massachusetts. Modern Healthcare (subscription required) (12/6)

Products & Innovation

Agencies release interactive map on health IT adoption
The Office of the National Coordinator for Health IT and CMS have released an interactive map that enables users to monitor advances in the use of health IT across the country. The map, featured at ONC's Health IT Dashboard, shows data on payments made under the Medicare and Medicaid EHR incentives initiatives, health information exchanges, and more. Modern Healthcare (subscription required) (12/7)

Policy & Reform Spotlight

Administration rejects partial expansion of Medicaid
Federal officials said they could not fund partial expansions of Medicaid enrollment by states under the Affordable Care Act. "Consistent with the law, there is not an option for enhanced match for a partial or phased-in Medicaid expansion," acting CMS Administrator Marilyn Tavenner said. A "blended rate" for the federal contribution to Medicaid had been on the table in previous rounds of deficit-reduction talks and in the administration's proposed budget. The Washington Post/Ezra Klein's Wonkblog (12/10), The Wall Street Journal (12/10), The Hill/Healthwatch blog (12/10)

Proposed essential health benefits regulations issued by HHS
HHS has proposed regulations on the essential health benefits needed for state health insurance exchanges. The regulations include the 10 specific benefits categories that must be offered in the exchanges, a plan requirement to cover at least one prescription drug in each specified category or class, annual cost-sharing limits, and the minimum value calculations for employer-provided health coverage. The regulations appendix also features a proposed benchmark plan for each state. Employee Benefit News (12/7)

ACC News

ACC and AHA release changes to current guideline development methodology
The ACC Foundation and American Heart Association have released a summary of proposed changes to the current ACCF/AHA guideline methodology in an attempt to continue developing timely clinical practice guidelines which meet new Institute of Medicine standards. The recommendations were derived from a two-day intensive Methodology Summit in December 2011 where the ACCF/AHA Task Force on Practice Guidelines spent time comparing and contrasting current methods against standards set forth by the IOM as the ideal methods for developing a trustworthy practice guidelines. “This was a natural next step in the evolution of our process and methods as we strive to integrate and respond to the continuous stream of new knowledge,” said Alice Jacobs, MD, FACC, immediate past chair of the ACCF/AHA Task Force on Practice Guidelines. “At the time the IOM report was released, we were already compliant with many of the proposed standards, but we used this as an opportunity to continue to improve.” Learn more about the changes.

ACC announces nominations of new leaders
The ACC is pleased to announce the new incoming officers for the year 2013. Keeping with tradition, President-Elect John Gordon Harold, MD, MACC, will be taking over as president of ACC; with Patrick T. O’Gara, MD, FACC, as president-elect and Kim Allan Williams, MD, FACC, as the new vice president. The Board of Trustees is also pleased to announce the following three additional members as trustees: Blair D. Erb, Jr., MD, FACC; Michael J. Mack, MD, FACC; and Debra L. Ness, MS. Read more about the incoming officers.

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SmartQuote

Put a grain of boldness into everything you do."

--Baltasar Gracián,
Spanish writer

This news roundup is provided as a timely update to ACC members and partners interested in quality health care topics in the news media. Links to articles are provided for the convenience of the health care professionals who may find them of use in discussions with patients or colleagues. Opinions expressed in ACC Quality First SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American College of Cardiology. On occasion, media articles may include or imply incorrect information about the ACC and its policies, positions, or relationships. For clarification on ACC positions and policies, we refer you to http://www.CardioSource.org.

External Resources are not a part of the CardioSource.org website. ACC is not responsible for the content of sites that are external to the ACC. Linking to a website does not constitute an endorsement by ACC of the sponsors or advertisers of the site or the information presented on the site.

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