This blog post comes to us from ACC President Dr. Douglas Weaver. Dr. Weaver is the Division Head of Cardiovascular Medicine, the Darin Chair of Cardiology, Director of the Henry Ford Cardiovascular Institute at the Henry Ford Health System and a professor of medicine at Wayne State University. On top of his numerous prestigious positions, Dr. Weaver is a resident ACC expert on cost-effectiveness.

The soaring cost of health care is arguably one of the largest problems within our current system. Health care costs in the US are projected to run $2.7 trillion in 2010, up nearly 30 percent from 2004. CMS estimates that health care spending will reach $4.3 trillion by 2017. By 2082, health care’s portion of the GDP will reach 49 percent, assuming that health care grows at only one percentage point more than the GDP (which is lower than the historic average of 2.5 percentage points), according to CBO. Of course, most of us may not be here in 2082, but how do we want to be remembered?

This rate of expenditure growth is both unacceptable not sustainable. As important is the fact that despite these rising costs, there is evidence that we are actually lagging in the provision of evidence-based care — by many measures we are slipping in producing a healthier America. Because of this, there can be no doubt that we will soon have some payment reform to both physicians and hospitals. It is the view of the ACC that physicians should be amply rewarded for providing the right care, for every patient, every time, instead of a system which rewards only volume and complexity of care. As it stands now, physicians would likely lose if they worked to improve prevention, continuity of care and eliminated that of either questionable or unproven benefit.

But while Congress and CMS contemplate and plan payment reform, we want to insure that the ACC is at the table to guide them to make decisions that will work. Cardiologists must get prepared by putting together the processes and measures to demonstrate the highest possible quality care to patients at every encounter. This means making the conscious decision to choose what works best at the lowest cost and apply it until we have found something of better value and more cost-effective to replace it. That’s it. No exceptions.

Last month, Health Affairs’ featured a section focused on the ability of “disruptive innovation” to spur health care change. In one article, the authors argue:

The achievement of lower costs ... requires the health care delivery system to get off a path where every new product and process aims at improving quality, regardless of cost, and onto one where changes in care reduce expenditures. This new path is not one of paying physicians, hospitals and drug manufacturers less to do what they have been doing .... What is needed is the development of new and different products and processes ....

One of these processes must be improving our application of guidelines and appropriate use criteria to every patient. We must take what we know to work and apply it in every situation possible. Plus, we must actively seek feedback on our performance to improve the care we provide.

The authors optimistically conclude – and I wholeheartedly agreed – that cost effectiveness is indeed possible:

Other industries have demonstrated the ability to deliver higher quality at lower prices, and there is no reason why health care cannot do the same.

Reform to the system is coming, no doubt about it. And in order to work, it’s going to have to address costs and the value received. If we can increase value and slow the rate of increase in cost, say to 1% or so greater than the GDP -- the impact will be enormous and yet we will not stunt innovation and further technological advances Let’s step up to the plate now and show Congress we’re ready to take an active role in cost and quality-related changes to the system.

- By W. Douglas Weaver, M.D., F.A.C.C., ACC President

* Dr. Weaver's post is the first in a new monthly series of guest posts by ACC leadership. Check back next month to see which ACC leader is sharing his or her thoughts on health care reform!