New ACC President Cathie Biga wants to improve quality reporting in cardiology

Because the Center for Medicare and Medicaid Services (CMS) plans to move toward a value-based payment system by 2030, Biga said the ACC needs to build leadership in quality with the National Cardiovascular Data Registry (NCDR) and the creation of a new cardiology board that will certify cardiologists and change the credentialing system. She said ACC is also expanding quality control metrics with new registries, including the new ambulatory surgical center (ASC) NCDR registry as more ASC and office based labs (OBL) open to provide ambulatory care at costs below hospital rates. 

"I think a lot of us are still grappling with what does a value-based payment model really look like, and how is that going to evolve over time. In my year in the ACC presidency, I am hoping to put that stamp of quality on every single thing we do, building not just on the NCDR but also at global quality solutions. We also want to be able to benchmark the quality of cardiovascular care across the world, because we spend a lot of healthcare dollars in the U.S., but our outcomes are not necessarily better than many other countries. We need to fix that and actually show that the things we do actually do make a difference," Biga explained. 

The role of new technology to aid cardiology

As cardiology starts to face staffing shortages and continued decreases in CMS payments, Biga believes technology advances need to be leveraged in cardiology to help improve outcomes, make workflows more efficient to do more with less, and to help cut costs.  

Biga said she posed a key question to attendees during her convocation speech: "What are we going to do to transform care?" she asked. Biga said it was meant to be an open-ended question for cardiology as a whole. A big takeaway for her at ACC was a business session keynote from Karen Maddox, MD, who spoke about quality improvement and its relation to patient outcomes and reimbursements. Ironically, after massive amounts of efforts the past decade to improve quality and detailed recording of quality metrics, Maddox showed compelling graphics showing flat lines and that measuring quality was not enough because it had not significantly impacted patient outcomes. Something else is needed to move the needle and Biga said this is especially important as Medicare plans to rapidly convert over to a value-based payment model.

Many of the solutions that can help were displayed on the expo floor, including telehealth and real-time remote monitoring systems. "I think this area will experience an explosion in use," Biga said.

Another major area that will likely see an explosion of use is artificial intelligence (AI). She said AI will begin playing a rapidly growing role in cardiology in the coming years to augment cardiologists and other clinical staff. And not just on the front lines of patient care, but also in the back offices where AI will play a growing role in IT systems, smoothing workflow, analytics, automated quality metrics capture and many other areas.

"We must use AI to reduce administrative burdens and improve patient outcomes," Biga explained. 

Biga is the first ACC president who is not a cardiologist

ACC has changed its focus over the past several years to include much more on the business of cardiology. Previous presidents have said this is because of continued declining reimbursements and rising costs require all cardiologists and especially managers and administrators to be much more cost conscious and innovative. ACC said Biga has been one of the key experts on cardiology business management for the college, which is one reason she is now president.

Biga was originally trained as a nurse, but later went into cardiology practice management. She has been an ACC member for over 25 years, during which time she served on multiple committees and was the inaugural chair of MedAxiom's Board of Managers. She has been a member of the ACC Board of Trustees for six years, serving as vice president this past year. She works as president and CEO of Cardiovascular Management of Illinois, a cardiology physician practice management company, She has worked with more than 100 providers in the Chicago area and partners in their cardiovascular service lines at 14 acute care hospitals. She has more than 40 years of experience as a registered nurse, service line director, hospital vice president and CEO, as well as 25 years of experience in physician practice management.

"I'm excited to bring my own set of leadership skills and perspectives to the ACC as we kick off the first year of our new Strategic Plan and celebrate the College's 75th anniversary," she said in an ACC statement. "The concept of 'standing on the shoulders of giants' is often referenced when talking about leadership changes and transformation over time. This concept is certainly true for me. There have been incredible leaders throughout the College's 75-year history and it's a true privilege to follow in their footsteps."

Biga has embraced the culture of team-based care in cardiology. As part of that change, she is one of only 72 non-physician cardiovascular team members out of almost 30,000 members who has achieved fellow of the ACC (FACC) designation based on her professional achievements.

"I have led throughout my career in a dyad model and my year as president will be no different," she said. "I bring extensive experience in cardiovascular health care delivery, innovation, quality and economic sustainability that I believe offers fresh perspectives and complements the competencies of my physician colleagues on the Board of Trustees. While my leadership in cardiology is on the administrative side, the end goals of optimizing patient care in physician led teams and optimizing patient outcomes are the same."

Other new officers for 2024-25 are ACC Vice President Christopher Kramer, MD; Treasurer Akshay K. Khandelwal, MD; Board of Trustees Members Bonnie Ky, MD, MSCE, and Lee R. Goldberg, MD, MPH; Board of Governors Chair Himabindu Vindula, MD, MS; and Board of Governors Chair-Elect David E. Winchester, MD, MS.

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