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US Health Care Policy and Reform: implications for cardiac electrophysiology

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

In response to unsustainably rising costs, variable quality and access to health care, and the projected insolvency of vital safety net insurance programs, the federal government has proposed important health policy and regulatory changes in the USA. The US Supreme Court’s decision to uphold most of the major provisions of the Affordable Care Act will lead to some of the most sweeping government reforms on entitlements since the creation of Medicare. Furthermore, implementation of new organizational, reimbursement, and health care delivery models will strongly affect the practice of cardiac electrophysiology. In this brief review, we will provide background and context to the problem of rising health care costs and describe salient reforms and their projected impacts on the field and practice of cardiac electrophysiology.

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Abbreviations

ACA:

Affordable Care Act (short for Patient Protection and Affordable Care Act)

AF:

Atrial fibrillation

AMI:

Acute myocardial infarction

CAD:

Coronary artery disease

CRT:

Cardiac resynchronization therapy

DOJ:

Department of Justice

FFS:

Fee-for-service

GDP:

Gross domestic product

GWTG:

“Get with the Guidelines”

HF:

Heart failure

ICD:

Implantable cardioverter-defibrillator

VBP:

Value-based purchasing

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Acknowledgments

This work is supported by a Veterans Health Services Research & Development Career Development award (CDA09027-1), an American Heart Association National Scientist Development grant (09SDG2250647), and a VA Health Services and Development MERIT award (IIR 09–092), and the Palo Alto Institute for Research and Education. The content and opinions expressed are solely the responsibility of the authors and do not necessarily represent the views or policies of the Department of Veterans Affairs.

Conflict of interest

Dr. Turakhia has the following disclosures: Medtronic, Inc., iRhythm, Inc., and Janssen Pharmaceuticals (research funding); Biotronik, Boston Scientific, St Jude Medical (honoraria for educational lectures); Precision Health Economics, St Jude Medical, Cyberheart (consulting); and Metrica Health, Inc. (equity).

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Authors and Affiliations

  1. Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, 111C, Palo Alto, CA, 9430, USA

    Mintu P. Turakhia & Aditya J. Ullal

  2. Stanford University School of Medicine, Division of Cardiovascular Medicine, Department of Medicine, Stanford, CA, USA

    Mintu P. Turakhia

  3. University of California, Berkeley, CA, USA

    Aditya J. Ullal

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  1. Mintu P. Turakhia
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Correspondence to Mintu P. Turakhia.

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Turakhia, M.P., Ullal, A.J. US Health Care Policy and Reform: implications for cardiac electrophysiology. J Interv Card Electrophysiol 36, 129–136 (2013). https://doi.org/10.1007/s10840-012-9773-3

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  • DOI: https://doi.org/10.1007/s10840-012-9773-3

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