2. To proactively pursue a new standard for health care reform that is centered on patient value and access to quality care. ACC’s Goal:

3. Key Quality First Principles A focus on patient value – the highest quality of care at the most effective cost Payment incentives for quality care Coordination across sources and sites of care Health care provider professionalism and partnership with patients Increased transparency Measurable health outcomes to provide accountability Access to quality care

4. We have our work cut out for us!

5. Preliminary Congressional Omnibus Survey Results Congress is less supportive of having medical societies be responsible for setting standards for quality measures and reporting –33% support using an existing federal agency –23% support public and private payers –23% Support a new public/private national entity –Only 10% support professional societies taking on this role. GOPs are more likely to favor payers and professional societies while Democrats favor federal intervention. Opportunity to increase awareness of ACC on Capitol Hill among both parties

6. In other ways we are on the right track!

7. Preliminary Congressional Omnibus Survey Results Congress generally favors physician reimbursement for reporting quality measures with 21% favoring the 4-5% reimbursement range Congressional leaders feel that better coordinated care delivery, payment reform, and focus on value are most important to health care reform.

8. ACC Public Opinion Survey Results The need for reform is critical. –52% of Americans say the costs of health care are too high. –77% unhappy with the way the health care system is being regulated. Quality and cost are key. –When it comes to health care reform, people in general want a new standard that focuses on quality and cost effective care. Half say high costs is the greatest shortcomings of our health care system. Doctors, advocacy groups must be involved in reform –86% of Americans would trust doctors and medical or patient advocacy groups to set standards for measuring and reporting quality. This is compared to 8% for health insurers.

9. ACC Public Opinion Survey Results It’s about the quality, not the volume. –Americans believe that quality of care is the fairest way to compensate doctors. –People in general want the ACC to advocate a new standard that focuses on quality and cost-efficient care. –64% percent agree that quality of care is most important; compared to 21% suggesting “performance-based” pay; 6% “patient outcome;” 6% “merit;” and 2% “volume” (the current system of payment). ACC Quality First objectives are on target. –The public widely supports ACC’s overall mission. –83% of Americans agree that the College's objectives are extremely or very important. “Helping to set a new standard for health care reform" is what the public feels the ACC’s top priority should be.

10. Quality First Efforts to Date …

11. Media Efforts –Radio media tour in late May (Reached 7M listeners) –Op-eds and LTEs being placed in local papers linking payment issues and health reform –Newsweek Advertorial –ACC Corner in Cardiovascular Business Magazine –Meeting w/New York Times reporter and editor –Press Conference to release public opinion poll data held Sept. 16

12. Advertising/Promotion Activities: –Internal Ads in Cardiology, JACC and ACC News –Print and online ads in “Roll Call,” “The Hill,” “National Journal,” and Politico.com. Ads timed to coincide with 2008 Legislative Conference –Planning large-scale ad campaign for 2009

13. Speaking Engagements Recent Activities: –National: Kaiser “Viewpoints” interview as part of the Health Aware Campaign AAMSE Annual Meeting; Brazilian Society of Cardiologists Annual Congress; National Congress on Health Reform European Society of Cardiology Assoc. of Black Cardiologists Meeting @ AHA Collocated National Congress on the Un and Underinsured and National Congress on Health Reform

14. Speaking Engagements Chapters: - The ACC’s health care reform message has been received at nearly every Chapter meeting this year. Thanks to everyone who has volunteered to spread the word! * Don’t forget to sign up to be a Quality First Ambassador. Email qualityfirst@acc.org to sign up today!qualityfirst@acc.org

15. Advocacy Efforts 2008 Legislative Conference Development of Payment Reform Pilot Legislation Appropriateness Criteria Pilot included in new Medicare law Proposal submitted to testify at ongoing health care reform hearings on Capitol Hill Working with partner organizations on reform efforts Hill briefing with key congressional staff on Sept. 23 Continue efforts to work with lawmakers on health care reform and related issues (ie: transparency; HIT; payment reform)

16. Quality First: Looking Ahead Year Two: BOT funding for 2009 will ensure physicians continue to be engaged and at the table when it comes to national health care reform. Plans are underway to continue with member education, but also raise the visibility of the ACC externally with patients and health care leaders.

17. Key 2009 Milestones –Health System Reform Summit II (February 1-2, 2009; Fairmont Hotel, Washington, D.C.). Registration opens Oct. 22. –Consistent external advertising throughout the year geared towards policymakers and health care leaders –ACC Health Care Reform Plan addressing health care proposals of new presidential administration –Increased visibility at AHA, ACC.09 and other ACC or health care-related events –Health Care Reform presentations at a minimum of 15 Chapter meetings and at least 10 outside venues –Continue to use ACC Communication vehicles to reach members

18. Member Resources IC 3 Program: –Designed for physician practices so they can measure and report performance; implement guidelines; enhance patient medication adherence; support continuity-of-care; enhance doctor-patient communications –Recently approved by CMS as a registry alternative for the Physician Quality Reporting Initiative (PQRI). –Enrollment kit online at www.ncdr.com.www.ncdr.com Quality First Chapter Toolkit w/sample op-ed, LTE and more (Posted on Chapter Affairs Extranet) Quality First Web Site: http://qualityfirst.acc.orghttp://qualityfirst.acc.org Lewin Report Blog: http://lewinreport.acc.orghttp://lewinreport.acc.org

19. Member Resources ACC PAC –Combining voices to impact the political process –Combining resources to send a power message to Congress –Combining power to promote quality and protect patients ACC PAC Goals: –Contribute to congressional campaigns that support the ACC’s legislative agenda –Gain BETTER access to key lawmakers, especially committee chairs and leadership –Build grassroots and fundraising potential to bring about election results favorable to the ACC’s advocacy goals

20. Member Resources ACC PAC Candidate Contributions in 2007/2008 Election Cycle: –Contributions made to over 235 candidates, leadership PACs and party committees thus far –Total of $818,079 disbursed –55% given to Democrats –45% given to Republicans –Our influence is growing, but we must do more

21. Member Resources WHY Contribute to the ACC PAC: –100% of your personal contributions are used to support the election of pro-physician candidates to Congress –With only 7% of members currently contributing, other specialty groups with better-funded PACs have an advantages at the decision-making table. –Elections are November 4!! WHO Can Contribute to the ACC PAC: –US Members only –Only personal funds, not corporate, can be used for political giving

22. Member Resources Pennsylvania PAC Facts: –In 2007, 164 Pennsylvania members contributed $35,645 –In 2008 (to date), 94 members have contributed $27,446 More Information: –Visit the ACC’s New PAC Web Site: http://www.accpacweb.org http://www.accpacweb.org –Contact Nick Morse at nmorse@acc.org ornmorse@acc.org 202-375-6373

23. American College of Cardiology http://qualityfirst.acc.org