Message from the President

Jeffrey B. Rich, MD  

STS News, Summer 2012 -- At STS we are making the most of the summer months, as the season marks the beginning of our Annual Meeting planning; however, before we start thinking about the future, I want to take this opportunity to let you know about a few of the exciting STS developments that occurred this spring.

Months of collaboration came to fruition on May 1 when CMS released a National Coverage Determination (NCD) for transcatheter aortic valve replacement therapy (TAVR). This NCD is a comprehensive approach to TAVR coverage that optimizes patient safety, while allowing Medicare beneficiaries across the country access to the latest in medical technology.

The NCD provides a clear pathway for the use of TAVR in clinical settings. It ensures that the pre-operative evaluation, inter-operative deployment of the valve, and post-operative care must be jointly shared by cardiologists and cardiothoracic surgeons, utilizing the heart team approach. This collaboration protects patients from less than ideal decision-making and technical problems in the OR, and helps ensure that the right devices are delivered to the right patients at the right time.

To learn more about the details and implications of the NCD for TAVR, please read Washington Scene on page 11.

One day after the NCD announcement, STS hosted a special session, “TAVR: Lessons Learned,” at the AATS Annual Meeting in San Francisco. This forum was a true culmination of our cooperative efforts. Representatives from the FDA, CMS, ACC, and Edwards Lifesciences, along with STS and AATS, came together to discuss how the TAVR approval process offered a new paradigm for device introduction and reimbursement.

For more information about this session, including a link to the session recording, see page 1.

In other TAVR news, the STS/ACC TVT Registry went live on Dec. 1, 2011. Currently, we already have 59 active participants, and we expect this number to grow as heart teams expand and new programs emerge. I want to give particular thanks to Drs. Michael Mack and Fred Edwards for their leadership in developing the registry.

Educating national policymakers on our surgical priorities has been one of the main goals of my presidency. To date we’ve had great success in this arena, as illustrated by our contributions to TAVR implementation. And with your help and PAC support, we can continue to drive the national conversation not just about medical device innovation, but also about fair payment models.

Fair payment models continue to be a top policy concern for both politicians and physicians. On April 27, I received a letter, on behalf of STS, from the Majority Republican members of the House Ways and Means Committee, seeking comments on Medicare physician payments and alternative payment models.

Committee members, including STS member Rep. Charles Boustany, Jr., from Louisiana’s 7th congressional district, invited us to make suggestions about how to incorporate quality measures into a new Medicare physician payment formula. The letter was also sent to other medical societies in advance of another end-of-year fight to delay cuts to physician payments.

I would like to thank our advocacy team and especially members of the STS Workforce on Health Policy, Reform, and Advocacy for helping me respond to the committee. It is important that we communicate our belief that the Sustainable Growth Rate formula must be repealed, and any new payment model should reward providers for patient outcomes based on risk-adjusted quality outcomes data and the efficient use of limited resources.

Citing the success of our STS National Database in our response, we urged the committee to develop a new physician payment model that utilizes registries as a tool to help ensure that physicians can—and have incentive to—control the growth rate of their services and payments by identifying the most effective and appropriate treatments for their patients.

As you and I know, one of the most powerful and reliable ways to affect physician practice is to engage physicians in the collection of outcomes data and to provide meaningful, risk-adjusted feedback. This information not only allows us to compare our outcomes to those of our peers, but it also allows us to evaluate the efficacy of therapies we provide, informing our decisions and the decisions of our patients and their families.

Another major springtime development was publication of the full results of the ACCF-STS Database Collaboration on the Comparative Effectiveness of Revascularization Strategies (ASCERT) study in The New England Journal of Medicine.

The clinical impact of this unprecedented study was explored during an STS/ACC “virtual town hall” meeting also held at the AATS Annual Meeting in San Francisco. To learn more about the ASCERT study, including a link to the “virtual town hall” session recording, see page 3

With these successful STS health policy achievements behind us, the Society is now transitioning into full-planning mode for our 49th Annual Meeting in January. The Workforce on Annual Meeting, chaired by Dr. John Conte, will conduct its program planning meeting in mid-August at STS headquarters in Chicago. The Workforce will coalesce annual meeting content, select abstracts for oral presentation and posters, identify invited speakers who will address topics most important to the specialty, and finalize STS University courses and breakfast sessions.

As my presidential responsibilities for Annual Meeting planning ramp up,

I encourage you to reach out to me with any suggestions, concerns, or ideas that you may have for our Annual Meeting. I want to be responsive to any ideas you may have to share.

Once again, it is a pleasure to serve you this year as STS President, and I hope you enjoy this edition of STS News.