Editorial Proposes Real Value Equation to Reduce Health Care Costs and Improve Quality of Care

February 4, 2014—The Society for Cardiovascular Angiography and Interventions (SCAI) announced the online publication of an editorial in Catheterization and Cardiovascular Interventions that proposes a new formula to define value in medical treatment by equating “real value” with appropriateness—already a widely used cost-effectiveness tool—together with clinically defined outcomes and patient-expected outcomes relative to costs. Peter L. Duffy, MD, is the author of the article, as well as Medical Director of the Cardiovascular Service Line at the Reid Heart Center/FirstHealth of the Carolinas in Pinehurst, North Carolina.

In the SCAI press release, Dr. Duffy commented, “Physicians are ready for new tools and strategies to improve patient care, and interventional cardiologists' long-standing commitment to innovation and quality improvement have enabled us to propose a solution and kick-start its adoption.”

As summarized by SCAI, the Real Value Equation captures the Institute of Medicine's six dimensions of quality: care that is safe, effective, efficient, timely, patient-centered, and equitable. Dr. Duffy also emphasizes that its application in everyday practice will help physicians provide better care by allowing them to customize care for the individual patient's needs while also adhering to best practices, guidelines, and appropriate use criteria (AUC).

The lens through which interventional cardiologists can view decisions is based on the following four parameters: (1) the extent to which the benefit of the procedure outweighs the risk, (2) the expected effect on the patient's quality of life, (3) how much the procedure reduces the long- and short-term risk of complications, and (4) whether the procedure will extend the patient's life expectancy with the level of quality they expect.

According to Dr. Duffy, although current efforts, such as AUC, have been effective at guiding treatment decisions, focusing on AUC alone will not result in better population-based outcomes and will not address long-standing concerns regarding patient-centered care and spiraling health care costs. Dr. Duffy calls for interventional cardiologists to continue their legacy as leaders in innovation and quality improvement by integrating appropriateness with clinical outcomes, patient expectations, and resource utilization into clinical practice.

“With heart disease care accounting for more than 40% of every health care dollar spent in the United States, interventional cardiologists are at the forefront of the conversation about how to change health care. We have the ability to make changes in our practice that will lead the way to meaningful change in this new phase of health care reform. As the Real Value Equation takes hold, the possibilities to apply it beyond cardiology to every field will only become clearer, which is truly exciting,” stated Dr. Duffy in the SCAI press release.