New Program to Recognize Physician Excellence in Ambulatory Cardiovascular, Stroke Care

2/13/2003

From: Brian Schilling or Barry Scholl, 202-955-5104 or 202-955-5197, both of the National Committee for Quality Assurance; or Toiya Honore of the American Heart Association/ American Stroke Association, 214-706-1456, email: toiyah@heart.org

WASHINGTON, Feb. 13 -- The National Committee for Quality Assurance (NCQA) and the American Heart Association/American Stroke Association today announced a collaboration to offer a joint program designed to recognize physicians who deliver high quality care to their patients who have cardiovascular disease or who have suffered a stroke.

The voluntary program, patterned after a successful program recognizing excellence in diabetes care, will assess physician performance based on accepted clinical guidelines. The groups simultaneously announced that they have released for public comment a draft of the measures that form the basis of the recognition program; interested parties are invited to comment on the draft through March 14.

"Recognizing the efforts of doctors who provide excellent cardiac care will drive higher performance across the board, and will give patients the information they need to make better informed decisions," said NCQA President Margaret E. O'Kane. "NCQA is extremely pleased to be working with the American Heart Association and the American Stroke Association. Their leadership in educating consumers and in supporting physician efforts to deliver evidence-based cardiovascular care is unparalleled." More than 60 million Americans have one or more types of cardiovascular disease. It is the leading cause of death in the United States, responsible for approximately 950,000 deaths each year. Despite evidence that reducing cholesterol levels and controlling high blood pressure are effective in preventing further health complications, many cardiac and stroke patients do not receive services that promote better cardiovascular health.

"The difference between living with cardiovascular disease and suffering from it can be as simple as what this program will measure," said Sidney Smith, M.D., professor of medicine, University of North Carolina at Chapel Hill and a past president of the American Heart Association. "Encouraging physicians to deliver these treatments more often -- and encouraging patients to seek out the physicians that do -- will mean more people managing their conditions, not suffering from them."

To achieve recognition under the NCQA/American Heart Association/American Stroke Association heart/stroke recognition program, individual physicians or medical groups will use a Web-based application to submit performance data related to their treatment of patients who have cardiovascular disease or who have suffered a stroke. The data will be evaluated against the program measure thresholds, which are based on American Heart Association/American Stroke Association clinical guidelines and NCQA HEDIS(r) measures. Physicians and groups who meet or exceed these thresholds will be recognized on a dedicated Web page, and callers to the American Heart Association/American Stroke Association toll-free number may be referred to the listing of recognized physicians.

Recognizing physicians has helped more Americans with chronic conditions to receive needed care and manage their conditions more effectively, as evidenced by a similar recognition program, the NCQA/American Diabetes Association Diabetes Physician Recognition Program (DPRP). Participating physicians report that they make improvements based on their performance results, and recognized physicians register treatment rates that far exceed national averages in all measures of diabetes care. As a result of this level of performance, patients of recognized physicians are far less likely to suffer adverse health conditions as a result of their disease.

The program's effectiveness has led purchaser coalitions seeking to contain costs and improve the quality of care to use physician recognition as the foundation of an initiative that will tie physician compensation to performance. The initiative, tentatively scheduled to be launched in two pilot cities this spring, will provide bonus payments to DPRP-recognized physicians based on the number of coalition employees with diabetes they treat. It is expected that the heart/stroke recognition program will eventually be used to provide financial incentives for superior performance.

"By recognizing and rewarding performance, we want to promote transparency and continuous quality improvement," said Raymond Fabius, M.D., global medical director, General Electric. "Physicians will be able to see their results, find ways to improve and deliver better care, and be rewarded for it. As a result, the quality threshold will continue to rise, and the physician and the patient, as well as the community at large, will benefit from that."

The draft program measures can be downloaded from NCQA's Web site, http://www.ncqa.org. Comments should be submitted online to hsrpcomment@ncqa.org. Final measures will be released in July, after completion of the public comment period and concurrent pilot testing.

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and manages the evolution of HEDIS(r), the performance measurement tool used by more than 90 percent of the nation's health plans. NCQA is committed to providing health care quality information through the Web and the media in order to help consumers, employers and others make more informed health care choices.

The American Heart Association spent about $389 million during fiscal year 2001-2002 on research support, public and professional education, and community programs. The organization has more than 22.5 million volunteers and supporters carrying out its mission in communities across the country. The association is the largest voluntary health organization fighting heart disease, stroke and other cardiovascular diseases, which annually kill about 950,000 Americans.

The goal of the American Stroke Association, a division of the American Heart Association, is to raise awareness of stroke and reduce disability and death from stroke. In its 2001-2002 fiscal year, the American Stroke Association spent almost $131 million on stroke-related research and programs.