The U.S. health care system is undergoing dramatic change. Efforts are underway to ensure access to care for millions of uninsured Americans, while at the same time the federal government is looking for ways to stem the tide of ever-increasing health care costs. With heart disease as the leading cause of death and one of the top contributors to Medicare costs, the American College of Cardiology (ACC) is focused on transforming health care delivery and payment systems to achieve the so-called “triple aim” of better health care quality, better health and lower costs.

The ACC believes that the current physician payment system must be realigned to address costs and quality, while also keeping the public’s interests and satisfaction foremost. The ACC supports payment reforms for improved coordination of care, team-based care delivery, the appropriate use of tests and procedures, and to improve medication adherence to treatment therapies.

Unfortunately, no one payment model has been proven effective and the College is looking to test several progressive pilots at the state and national level over the next several years that could contribute significantly toward a better understanding of what types of incentives are needed to facilitate better care coordination, adoption of health information technology, and workflow redesign to ensure high quality, cost-effective care.

On the care delivery front, the ACC is already leading the way to improved care through its ongoing development of science-based clinical guidelines and appropriate use criteria that help physicians and other health care providers ensure the most appropriate treatment or therapy for each patient. In addition, the College’s National Cardiovascular Data Registry (NCDR®) is the largest cardiovascular patient database in the U.S. The suite of six registries measure outcomes and provide feedback to hospitals and doctors and are used to assess the quality of care that is delivered and to pinpoint areas where gaps in care exist. The ACC’s many national quality improvement initiatives also help hospitals and practices reduce costly hospital readmissions related to heart failure, ensure appropriate use of imaging procedures and provide care that is first and foremost patient-centered.

Moving forward, the ACC is committed to further development of clinical decision support tools and educational resources and programs that harness new technologies and meet the educational needs of health care professionals at every stage of their career. Additionally, the ACC is piloting ways to increase primary and secondary prevention through the development of tools to monitor and encourage patient adherence to medications, as well as increase public awareness and understanding of heart disease and impacts of lifestyle choices.

The U.S. health care system has the potential to be a leading example and the best in the world, and we need to continuously strive towards its sustainability for the benefit of our nation’s patients. To that end, the College is committed to working collaboratively with all willing stakeholders — Medicare, private payers, Congress, patients and others to test innovative payment methodologies and care delivery vehicles that will ultimately lead to not only cost savings, but millions of lives saved.