D2B-Sustain the Gain

Transitions in Care-Heart Failure

Patient Centered Care Transformation

Patient Centered Care Transformation

The IC3 ProgramThe IC3 Program

ACC Quality 2009ACC Quality 2009

Help clinicians thrive in a performance-

based reimbursement

system through thesystematic practice,

timely reporting,and continuous improvement of

quality

Goal

ImprovingContinuous Cardiac Care

ImprovingContinuous Cardiac Care

Outpatient Performance Measures

CAD, Afib, HTN,Heart failure,

Diabetes, Rehab-----------ACC/AHA

PCPIPQRINQF

Quality improvement

• Practice workflow redesign

• Transactional quality and management

• Incentives

Office-based quality improvement program that

enables participants to select, based on

practice characteristics, the most appropriate

level of engagement

What is it?

Data PerformanceImprovement

Incentives Research

Community Education

The IC3 Program

Community Building

The IC3 national network of practices

dedicated to high quality CV care.

Interactive communication.Best practices.

Education

Educational programming.

Clinical guideline updates.

Selection of EHR vendors.

Billing and coding.

Data Collection

Office-based registry.

Collect and use patient care data more effectively.Coordinate care.Benchmarking.

Demonstrate quality of care.

Performance Improvement

Practice assessment.

QI tools.Decision support

(CardioPATH).

Recognition and Rewards

Incentives.Recognition.ABIM MOC.

Payers.Malpractice.tipping points

Research

New insights on care delivery.

Impact of program.

Practice-Based Research Network.

CAD Performance Measures

• BP Measurement• Symptom & Activity

Assessment• Smoking Assessment• Anti-platelet Therapy

• Lipid Profile• Use of Lipid Therapy

-blocker post-MI• ACE/ARB in EF & DM

• Screening for Diabetes

CHF Performance Measures

• LVEF Assessment• Weight Measurements

• BP Measurements• Clinical Symptom

Assessment• Activity Assessment

• Signs of Volume Overload• Patient Education -blocker in EF • ACE/ARB in EF

• Warfarin for Afib• Initial Lab Tests

Current ACC/AHA Performance Measures

Current ACC/AHA Performance Measures

Afib Performance Measures

• Thromboembolic Risk– Prior CVA/TIA– Age ≥75– Hypertension– Diabetes– Heart failure or EF

• Warfarin use in High-risk pts• Monthly INR in pts on warfarin

Cardiac Rehabilitation PMs

• Referral to a Rehab Program

– Within 12 months of• ACS• PCI

• CABG• Valve Surgery

• Transplant– Stable Angina

Diabetes Performance Measures

– Poor HbA1c (>9%)– LDL Control (<100)– BP Control (<140/80)

2009: prepare practices to succeed2010: make quality business case2011: link learning, performance, $2012: Quality First Network

Quality Vision, near and far