ACC ADVOCACY 2019 IN REVIEW
The past year was a busy one for ACC Advocacy. Here are some highlights of the many efforts to improve access to care and practice stability, reduce administrative burden, increase member engagement, promote value-based care, and optimize care and improve population health:
Reducing Administrative Burden and Prior Authorization
As part of strategic efforts to develop and advocate for public policy solutions to issues that hinder patient care and contribute to administrative burden and clinician burnout, the ACC worked closely with stakeholders across the house of medicine, as well as ACC's State Chapters on several efforts. For example, as part of its work with the Regulatory Relief Coalition, the College helped craft legislation and secured introduction of the Improving Seniors' Timely Access to Care Act of 2019 to address prior authorization in Medicare Advantage plans. Additionally, more than 1,200 records of authorization denials from 38 states have been submitted through ACC's Prior Authorization Reporting Tool (PARTool) to date and conversations with payers and other stakeholders on opportunities to mitigate this burden and advance solutions continue.
The ACC also developed policy positions and submitted comprehensive comments to the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health Information Technology on the Information Blocking and Interoperability proposed rule with the goal of mitigating burdens and unintended consequences related to interoperability and information blocking. In addition, the College made significant contributions to efforts that avoided controversial payment changes for E/M services and redefined E/M documentation standards in ways that will be less burdensome.
Promoting Value-Based Care
Promoting awareness, developing products and enhancing communications to educate and assist members in the ongoing transition to alternative payment models and value-based payment is a strategic advocacy priority for the ACC Advocacy team. As part of this effort, the College participated in the Core Quality Measure Collaborative to develop a set of measures that is expected to be used by both private and public payers. The ACC also promoted transition from volume- to value-based care by means of eliminating barriers to participating in alternative payment through support of the Medicare Care Coordination Improvement Act of 2019 and member education tools like the revamped APM Hub and QPP Hub. Most recently, the ACC convened its first Value-Based Care in Cardiology Forum, bringing together clinicians and representatives from nine payers, the Center for Medicare and Medicaid Innovation, health systems and industry for discussions around experiences in current payment models and the ideal characteristics for future models.
Efforts to promote member engagement and value through proactive, ongoing interface with and between member constituencies, medical society partners, policymakers, public and private payers and health systems were in full force in 2019. More than 1,600 grassroots messages were sent to members of Congress, and this year's Legislative Conference was the best-attended conference yet with 505 attendees, including 94 FITs, participating in 316 Hill meetings to advocate on behalf of the cardiovascular profession and patients. On Capitol Hill, members represented the ACC in numerous Hill meetings, policy roundtables, informational briefings and calls directly with lawmakers on key topics like drug pricing, health care innovation, veterans affairs and the flu vaccination. A total of 39 practice visits were held by ACC members with members of Congress while they were in their districts.
The ACC Political Action Committee (PAC) had a very successful 2019 with more than 1,300 ACC members contributing to the PAC, raising more than $520,000. FIT participation in the PAC tripled from 2018, with more than 125 FITs contributing to the PAC in 2019. The PAC hosted two fundraising challenges in 2019: the annual State Giving Challenge – raising $96,000 from the state chapters – and the first-ever ACC Section PACtoberfest – raising $31,000 from the 22 member sections. The PAC disbursed $390,000 last year to Congressional champions of the College’s policy priorities. Effective Jan. 1, ACCPAC has now become HeartPAC – stay tuned for an exciting election year!
Optimizing Care and Improving Population Health
Advocating for policy approaches to optimize cardiovascular care and outcomes and improve population health was also a major focus in 2019, whether it was supporting legislation to provide coordinated care for children with complex medical conditions; engaging with members of Congress on the observed increase in long-term mortality in peripheral arterial disease (PAD) patients treated with paclitaxel-coated balloons and paclitaxel-eluting stents; or joining with the Campaign for Tobacco Free Kids and other medical societies and public health groups in support of Tobacco 21 legislation and a ban on flavored e-cigarettes. Most recently, the ACC successfully advocated for increased funding levels in the FY20 appropriations spending package for cardiovascular disease research and prevention programs at the National Institutes of Health and the Centers for Disease Control and Prevention (CDC). This same package also included language for increased PAD awareness and education activities at the CDC.
Advocacy in 2020
The below issues are those which ACC is currently devoting much effort. Click here for more information and to see how you may help.
Improving Seniors’ Timely Access to Care Act of 2019 (H.R. 3107) which would streamline prior authorization practices and increase transparency and accountability in the Medicare Advantage program.
Medicare Care Coordination Improvement Act of 2019 (H.R. 2282/S. 966) which would modernize physician self-referral prohibitions to promote care coordination and facilitate participation in alternative payment models (APMs) under the Medicare program. Additionally, members of Congress should encourage CMS to thoroughly consider input provided by the ACC and other stakeholders while modernizing related regulatory language.
Increasing Access to Quality Cardiac Rehabilitation Care Act of 2019 (H.R. 3911) which would authorize advanced practice providers to order and refer patients for cardiac and pulmonary rehabilitation under Medicare and begin supervising patients’ day-to-day cardiac and pulmonary rehabilitation care (CR/PR) in 2020 – rather than 2024 (current law).
South Asian Heart Health Awareness and Research Act of 2019 (H.R. 3131) which would fund grants through the NIH and CDC to conduct research on cardiovascular disease and other heart ailments among South Asian populations living in the United States.
Bills to combat the youth tobacco epidemic by raising the tobacco age to 21 and imposing restrictions on flavored e-cigarettes: