In 2014 the CASTS Has Pursued Efforts on Several Fronts

CASTS Update June 2014

During the last year the California Society of Thoracic Surgeons (CASTS) has undergone reorganization. The CASTS Board of Directors now includes Junaid Khan, (president), Andreas Kamlot, Tony Caffarelli, Steve Rossiter, Luis Castro, James MacMillan, Jeff Milliken (treasurer) and Joe Carey. Joe Carey has served as interim Executive Director since the resignation (and recent passing) of Ed Fonner. These changes and CASTS activities have been documented at

In 2014 the CASTS has pursued efforts on several fronts:

1)The CASTS, with the support of the CAACC, has focused on expansion of public reporting because of the diminishing role of CABG among cardiovascular interventions. PCI represented 70% of procedures and 76% of hospital readmissions for adverse events in the CCSIP 2011-2012 report. A hearing was held in Sacramento on April 24 on SB 830. James MacMillan (CASTS past president and CCORP CAP member), Bill Bommer (CAACC past president) and Tim Madden (CAACClobbyist) attended. There is no serious opposition to expansion of public reporting for PCI and valve procedures. The status of the legislation will be discussed at the CASTS June 28 meeting.

2)Joe Carey and CASTS physician liaison Claude Brandeau met with Bernice Hecker MD, Executive Medical Director for Noridian (CMS contractor)on April 27 regarding Title 22 issues. She is agreeable to the second assistant as long as the role is documented appropriately. Junaid Khan, CASTS president, is preparing a summary of appropriate documentation.

3)The CASTS reporting website been revised and updated.This was reviewed with Dr. Hecker who is strongly in favor of the reporting program. Medicare would like to have better performance data on providers. At present the CCSIP is the only source of comparative data for California heart hospitals. It is rigorously documented and offers a source of information in advance of public reporting, which will take a few years to get off the ground.

4)CASTS is establishing a hospital participation program that will allow access to the CCSIP data and to regional collaborative meetings. Participation fees will provide sustainability for the program to produce annual hospital reports and maintain regular performance improvement meetings to share process data.

The CASTS would like to have input from all heart team members. Expansion of public reporting will require increased attention to accuracy in database coding, especially for cardiologists who may be unfamiliar with risk factors that affect case mix adjustment. We would also like to turn our attention to achieving measurable improvements in patient care through our quality control efforts. With these thoughts in mind we have asked Dr. Jeff Rich of Virginia to attend the CASTS annual meeting on June 28 to discuss the legacy of Ed Fonner and the Virginia experience. Justine Norwitz of the Washington Surgical Care Outcomes Assessment Program (SCOAP) will discuss progress in their state.

We hope your hospital quality control managers and heart team members will join us on June 28. The agenda is attached.

Junaid KhanJoe Carey

President, CASTSInterim Executive Director