The changing healthcare market and how it has influenced the treatment of cardiovascular disease - Part 1

The dramatic transformations taking place in the healthcare environment hav e created a new paradigm for healthcare and pose far-reaching changes for c ardiovascular care. This 2-part paper reviews these changes and discusses t he major implications for cardiovascular specialists, based on literature r eviews and summaries of legislative initiatives. The new healthcare paradig m focuses on a continuum of care, wellness maintenance and promotion, accou ntability for the healthcare of defined populations, and provider different iation based on ability to add 'value' to the patient's healthcare outcome. This paradigm will become 'standard operating procedure' in the cardiovasc ular market. As a result, major areas of change in the cardiovascular envir onment include: continuing growth of managed care arrangements, expanding p hysician and other payment reforms, growing influence of state and private payer initiatives, expanding role of 'centers of excellence,' continuing su rplus of physicians, growth in pharmaceuticals and new technologies, and ex tension of evidence-based guidelines. Practice guidelines, in particular, will become an integral part of medical practice and will represent the standards against which medical practice w ill be measured. Given the prominent position of cardiovascular disease in healthcare, cardiovascular specialists will remain in the forefront of thes e developments.