Separate Paths

Cardiology Review® Online, December 2014, Volume 30, Issue 6

As of January 5, 2015, the Centers for Medicare & Medicaid Services recognizes interventional cardiology as its own distinct physician specialty.

Mike Hennessy

As of January 5, 2015, the Centers for Medicare & Medicaid Services (CMS) recognizes interventional cardiology as its own distinct physician specialty. The result of several years of lobbying by the Society for Cardiovascular Angiography and Interventions (SCAI), the new designation is a major achievement, according to the SCAI, because this recognition will enhance the ability of interventional cardiologists to represent their profession and their patients.

Several months ago, the SCAI offered additional details about why it was pursuing this goal. In an update to its members, the SCAI explained that interventional cardiology “has evolved to a point where many of the patients we treat and the treatments that we can offer are significantly different from those of general cardiology and other cardiovascular subspecialties. Having our own designation will help us to ensure that our concerns and priorities will receive sufficient consideration and will not be lumped in with those of others. This is especially important in today’s healthcare environment, when CMS and other payers are profiling providers based on the costs of the services they deliver to beneficiaries. SCAI expects that payers will soon be calculating the costs of procedures performed by interventional cardiologists and comparing those costs to those for treatments provided by noninvasive cardiologists, potentially leading to unfair, ‘apples-to-oranges’ comparisons of practice patterns and erroneous reporting of our members as outliers.”

The issue of unfair comparisons to outcomes achieved by other cardiologists and internists is at the heart of this effort, especially as those quality metrics are increasingly tied to reimbursement. SCAI secretary Peter Duffy, MD, told one news outlet that the move from a pay-for-volume environment to a pay-for-value system requires that interventional cardiologists be compared to one another in order to get a true picture of the value they bring.

The sicker, more complicated patients seen and treated by interventional cardiologists often have poorer outcomes that can impact quality-of-care performance scores. Advocates say the new designation allows these outcomes (and the level of resource utilization required to achieve them) to be seen and evaluated in the proper context.

Duffy has also noted that the new designation can benefit other noninterventional cardiologists as well, because now both specialists can be reimbursed for their work treating the same patient with less chance of having claims denied.

Achieving recognition as a separate and distinct specialty is an important milestone for interventional cardiology (as it was for cardiac electrophysiology several years ago). The question now is how this will play out against the changing reimbursement landscape, and whether other subspecialties within cardiology (heart failure-transplant cardiology?) will seek to follow the same path.

Thank you for reading.

Mike Hennessy

Chairman and CEO