title: The changing healthcare market and how it has influenced the treatment of cardiovascular disease--Part 1.
abstract: The dramatic transformations taking place in the healthcare environment have created a new paradigm for healthcare and pose far-reaching changes for cardiovascular care. This 2-part paper reviews these changes and discusses the major implications for cardiovascular specialists, based on literature reviews and summaries of legislative initiatives. The new healthcare paradigm focuses on a continuum of care, wellness maintenance and promotion, accountability for the healthcare of defined populations, and provider differentiation based on ability to add 'value' to the patient's healthcare outcome. This paradigm will become 'standard operating procedure' in the cardiovascular market. As a result, major areas of change in the cardiovascular environment include: continuing growth of managed care arrangements, expanding physician and other payment reforms, growing influence of state and private payer initiatives, expanding role of 'centers of excellence,' continuing surplus of physicians, growth in pharmaceuticals and new technologies, and extension 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 will be measured. Given the prominent position of cardiovascular disease in healthcare, cardiovascular specialists will remain in the forefront of these developments.
authors.affiliation: Rollins School of Public Health at Emory University, Atlanta, GA, USA.
authors.forename: E R
authors.initials: ER
authors.lastname: Becker
authors.forename: D C
authors.initials: DC
authors.lastname: Morris
authors.forename: S D
authors.initials: SD
authors.lastname: Culler
authors.forename: P D
authors.initials: PD
authors.lastname: Mauldin
authors.forename: L J
authors.initials: LJ
authors.lastname: Shaw
authors.forename: J D
authors.initials: JD
authors.lastname: Talley
authors.forename: W S
authors.initials: WS
authors.lastname: Weintraub
mesh_terms: D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000191:economics* / Q000628:therapy*; D017281:Cost of Illness; D017048:Health Care Costs / Q000706:statistics & numerical data; D019981:Health Care Sector / Q000639:trends*; D005102:Health Expenditures / Q000639:trends; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration; D014481:United States / Q000453:epidemiology; D019564:Unnecessary Procedures