In the last hours before Medicare releases its final regulations, an open letter to President Obama in America’s top newspapers today asks him to intervene on behalf of America’s heart patients.

The Centers for Medicare and Medicaid Services (CMS), which runs the Medicare program, is scheduled to release the final 2010 Physician Fee Schedule by November 1. If the regulations are implemented as proposed, cardiologists will see cuts of 27-40 percent or more beginning January 1 for common cardiac tests used to diagnose and treat heart disease. The cuts to cardiology are in addition to the 21.5 percent reduction all physicians face in 2010 due to the flawed Sustainable Growth rate formula, and will force practices nationwide to lay off staff, close offices and otherwise reduce access to lifesaving treatments.

The letter calls upon the President to intercede with CMS to prevent the cuts to cardiology. The ads ran in The Washington Post, USA Today, The New York Times, and the President’s hometown newspaper, The Chicago Tribune. Click here to see the letter..

Medicare regulatory changes expected to be finalized as early as Oct. 30 pose an imminent threat to 80 million patients in America suffering from heart disease, especially for the nearly one in five Americans over the age of 65 living in rural areas. At issue is the proposed cutback of Medicare reimbursement rates to cardiologists for lifesaving diagnostic testing — rates could be slashed in some cases by an additional 40 percent for imaging and other vital diagnostic tools cardiologists use daily to save lives.

Many cardiologists who operate in rural areas believe the proposal will force them to discontinue providing diagnostic and imaging services – and even close their outreach offices completely – since many of these operations run at a fiscal loss but offer an important service to remote communities.

Dr. Bruce Murphy, a cardiologist with Little Rock Cardiology Clinic, which has 33 satellite offices serving rural communities, and his patients illustrate the real-life impact of this issue here:

http://www.youtube.com/watch?v=Pco1n8sBLWA

If these cutbacks pass, cardiologists like Dr. Murphy will have to send their patients to hospitals instead, which means that many rural patients will face long-distance travel, out-of-pocket costs that are as much as five times higher than in-office co-pays and wait times for tests and test results that will take days, not hours as currently is the case when tests are performed in the cardiologist’s office.

I urge you to join the Guarding Hearts Alliance (www.guardingheartsalliance) in our fight to defeat this proposal and protect patient access to quality cardiac care.

Dan Caldwell

Arkansas

Dennis, a patient in his 50’s, recently came to our practice for a stress test that his primary care physician ordered.  Dennis had no history of heart disease but did have multiple risk factors for it. One of our cardiologists read the stress test immediately and when it showed abnormalities we performed an echocardiogram That too was abnormal and our cardiologist spoke with Dennis’ primary care physician immediately. It was decided that Dennis needed a heart catheterization that very day.  Dennis was taken to the hospital where another one of our cardiologists performed the heart catheterization. The heart cath showed that Dennis had multiple blocked arteries that coronary artery bypass surgery.  The cardiothoracic surgeons were consulted and Dennis was referred for surgery on the same day. 

Dennis was to leave for Florida two days after his stress test.  Dennis may not have been able to have his stress test prior to his trip at the hospital due to scheduling.  Would Dennis have been okay vacationing in Florida with multi-coronary artery disease? Would Dennis have made it back home or would he have had a heart attack, perhaps a fatal one?

I am proud to be part of a practice that provides in-office imaging for its patients, and I know Dennis sure is glad we were able to act quickly on his behalf. There are a lot of people just like Dennis whose lives may be saved by being able to access the critically important tests cardiologists need to diagnose and treat heart disease.

Patricia Reed, RN

St. Louis MO

I know that healthcare reform is “top dog” right now, but I am very concerned that the under-the-radar Medicare regulations being proposed will take effect January 1 and people will wake up to discover their access to cardiac care has been severely affected without a single piece of legislation ever being enacted.

It’s easy to lump the two-legislation and regulations-together but the reality is that the proposed Medicare rules will limit cardiologists’ ability to provide care, especially in rural areas. Folks in the “big city” don’t realize how far patients have to travel to access their cardiologist or obtain a test to diagnose their heart disease. Doctors who open clinics in rural areas a couple days a week so patients don’t have to drive 70-100 miles for care do so because it’s the RIGHT THING TO DO, not because they make a lot of money from it.

But if the Medicare cuts go through, physicians will be forced to reduce those rural services because there’s just no way they can make it work financially. They will have to make tough choices: lay off staff, or close the twice-a-week office in a rural county? Let the lease expire on that expensive mobile echo machine used in rural offices, or not hire an additional physician to meet the needs of the increasing cardiac needs of the baby boomer generation?

Given that heart disease is America’s Number One killer, we need to focus on making sure patients have access to the care they need when they need it. When you have a heart problem, it needs to be addressed IMMEDIATELY or patients could die. And rural residents deserve that access to cardiac care-they are the farmers, the miners, the small business owners that help keep this country running.

Eddie Barber

Tupelo Mississippi

I am in this fight to maintain the doctor-patient relationship and to protect my patients. I favor reform that will allow us to take care of our patients appropriately and to the best of our abilities. If the bureaucrats and lawyers who dictate policy can allow me to do so without interfering in my relationship with my patients and without placing them in harm’s way then I will agree to their proposals.

However, as a result of the CMS 2010 proposals and the ongoing debate in Congress over healthcare reform I am very concerned about the well-being of my patients, their families and all Americans. Every week cardiologists, like myself,  see patients in their offices whose lives have been saved by having quick access to the critical tools needed to diagnose and treat their heart disease.

It is so satisfying as a physician and better for the patient to be able to get the patient in for the right imaging test right away in our office; to discuss the results with the patient that same day; and decide on the best treatment options to keep that patient functioning with the best quality of life possible.

The right test for the right patient at the right time, interpreted by qualified professionals who adhere to appropriateness criteria and evidence based medicine and who know the patient’s medical history—that’s what patients deserve and that’s what cardiologists must have access to in order to be able to provide the best possible care.

Arie Szatkowski, MD, FACC

Tennessee

I want to let folks know how important it is for rural residents in Arkansas to have access to cardiac care. Each week we bring a portable imaging machine into our small rural towns so people who live in the country can get the tests they need to diagnose and treat their heart disease. I know many of these elderly residents would not drive all the way to Little Rock – a 70-mile trip one way—for their care. It just takes too much out of them. But they will go to their local office to receive care because it’s convenient and it gives them the same high-quality care they’d receive in the main office in Little Rock. If we didn’t have the ability to provide these mobile machines, I believe we’d have much higher rates of cardiac death in our rural areas”.

David Mego, MD, FACC/Little Rock Cardiology Clinic

We’re really excited about the number of people who have visited GuardingHeartsAlliance.org so far. It’s heart-warming (sorry, cardiologist humor) to see so many patients and caregivers learning about the issues. When it comes to cardiac care, the most expensive heart attack is the one we could’ve prevented. Too many times people ignore the symptoms of heart disease until “the big one” happens…but it doesn’t have to be that way. The amazing imaging technology that cardiologists use to diagnose heart disease in its early stages helps patients avoid that potentially fatal heart attack. I see patients all the time who don’t believe they are at risk for a heart attack but get dragged in by a spouse. Then they see the image of their heart clear as day with partial or full blockages of their arteries. The light bulb goes off and they get serious about taking care of themselves. That’s why it’s so important to make sure patients have access to these lifesaving tests in the doctor’s office. We save lives every day by putting patients first.

Aalya Crowl, M.D./Virginia Cardiovascular Specialists

Thanks for visiting our new Website, GuardingHeartsAlliance.org! Our goal is very simple: America has the best cardiac care in the world and we want to keep it that way – for our patients and the people who love them. It’s a tough fight because heart disease kills more Americas every year than cancer, accidents and diabetes combined.  We have come a long way to reduce death and heart-related illness—down by 27 percent in just the past 10 years! We support Medicare regulations and health care legislation that put the patient first … in our world, that means making sure cardiac patients have access to the tests their doctors use to diagnose and treat their heart disease. Sounds like a no-brainer, right? But in reality, access to lifesaving technology is being threatened, both by proposed Medicare regulations and in certain provisions of health care legislation. That’s why Guarding Hearts Alliance (GHA) was created: to make sure the amazing tools we have in the fight against America’s Number One killer are available to everyone who needs care. Let us know what you think!