After getting shot down on his health reform strategy by the Legislature (and a massive $40 Billion budget deficit), ‘Ahnold’ is still working on reforming the system. This time he appears to be listening to the ACC on our “Fixing Health Care from the Inside Out” theme (as, by the way, is Boston surgeon and columnist Atul Guwandi, who is using our theme as if it’s his -- I guess that’s flattery). Schwarzenegger has developed the Right Care Initiative to improve quality and efficiency of care across California to improve quality, and hopefully reduce public coverage costs of unnecessary care. He is focusing first on diabetes and CV care. I have been asked to chair their Right Care Task Force on Payment Incentives to Promote Quality and Outcomes. California sponsored the first meeting of the taskforce this week in Southern California -- and it includes the CEOs or CMOs of PBGH (the nation’s largest private purchaser), insurers, medical groups, integrated systems, and the IHA (Integrated Healthcare Association -- the nation’s largest P4P system with over $500 million in payment rewards to docs per year).

Basically, given that California generally has a lead other states in widely testing these concepts and in IT adoption, the Governor notes that the actual conformance to managing BP< 140/90, LDL<100, and HbA1C < 9 in California is not much above the national average, and they want to know why, and how to turn that around. The state wants to consider how they might reassess how to provide the incentives for docs, patients, and health insurers to achieve better results. I definitely will also be able here to highlight the potential for physician networks, insurers and Medi-Cal in the state to begin working with ACC on NCDR and IC3 and AUC projects, and perhaps on imaging and CAD improvement projects. What an opportunity!