July 26, 2016 — The Centers for Medicare & Medicaid Services (CMS) has proposed the creation of new bundled payment models for patients who have a heart attack or undergo coronary artery bypass surgery. Several medical societies released statements on the proposed models, including the Society of Thoracic Surgeons (STS) and the American College of Cardiology (ACC).
According to the statement from Joseph E. Bavaria, M.D., STS president, the society has been a longtime advocate of the heart team, which facilitates better, more coordinated, patient-centered care. He urged CMS to work with STS and implement truly meaningful Medicare payment reform that emphasizes care quality and puts the Medicare beneficiary first.
Watch the VIDEO “How to Build An Integrated Heart Team.” Brijeshwar Maini, M.D., and Brian Bethea, M.D., from Tenet Florida’s structural heart program, explain the importance of building a good heart team and how that team should interact.
By passing the landmark Medicare Access and CHIP Reauthorization Act (MACRA), Bavaria said Congress is moving away from fee-for-service medicine and toward a payment structure based on quality. He believes the STS National Database will be an important tool in helping to accomplish the goal of linking payment to quality, rather than volume.
The Adult Cardiac Surgery Database, a component of the STS National Database launched in 1989, houses more than 5.9 million surgical records and gathers information from more than 90 percent of the groups that perform cardiac surgery in the United States. Data from the database facilitate nationwide quality improvement initiatives, robust public reporting via Consumer Reports, participant credit in U.S. News and World Report’s ranking of best hospitals, and help guide patients and their families as they make life-altering decisions.
Bavaria believes that the STS National Database could facilitate physician-led, quality-based payment reform in the way that Congress intended.
“It is our hope that yesterday’s announcement will set the stage for collaborations between STS and CMS that will produce meaningful reform resulting in better care for our patients,” he concluded.
In a statement from ACC President Richard A. Chazal, M.D., FACC, the American College of Cardiology supports the movement toward value-based care. Improving quality care and value are central to the ACC’s strategic plan. The CMS proposed regulation on bundled care models for heart attack and bypass surgery, along with a payment incentive model intended to increase utilization of cardiac rehabilitation, represent efforts in this direction. In addition, CMS is moving the right direction by proposing tracks under these new models that may qualify as Advanced Alternative Payment Models under MACRA — providing new ways for specialists to be rewarded for delivering quality care.
Chazal noted that while ACC supports the concept, it is important that bundled care models be carried out in such a way that clinicians are given the time and tools to truly impact patient care in the best ways possible. Changes in payment structures in healthcare can pose significant challenges to clinicians and must be driven by clinical practices that improve patient outcomes.
“We are optimistic that CMS will listen to comments, incorporate feedback from clinicians, and provide ample time for implementation of these new payment models. Our ultimate goal is to improve patient care and to improve heart health,” Chazal concluded.
For more information: www.sts.org, www.acc.org
July 29, 2024 
