Even though supervised rehabilitation has been shown to improve health outcomes following a cardiac event, a minority of affected patients in the U.S. use such programs, so Medicare is trying cash incentives to increase participation.
Cardiac rehab has demonstrated a much lower incidence of complications and a higher quality of life. Yet according to modernhealthcare.com, only approximately 20 percent of heart patients choose to partake in cardiac rehab.
Because significant obstacles include prohibitive costs and geographic distance, the Centers for Medicare & Medicaid Services (CMS) has created an experimental plan to motivate both patients and practitioners to take advantage of available follow-up care.
Following heart attacks and/or coronary artery bypass surgery, CMS will pay designated hospitals for Medicare beneficiaries’ cardiac rehabilitation sessions, using a pre-set payment scale. Facilities are free to dispense the compensation as they see fit, tailoring the funds to individual needs such as transportation or referral costs.
One additional hurdle is that Medicaid does not cover home-based rehab. Dr. Nanette Wenger, cardiologist and professor at Emory University’s School of Medicine in Atlanta, said although still in its early days, she believes that full coverage for cardiac home care is “the future of rehab.”
CMS will offer the program for a five-year period beginning July 1 in 90 areas comprising approximately 1,320 hospitals. Since one-half of those facilities also use Medicare’s “bundled-payment” program, CMS will use the differential to measure effects of their new incentive model.
“What we think is so creative about this approach is it gives programs additional resources, and they can figure out how to solve the problem their patient population is facing,” said Sue Nelson, vice president of federal advocacy for the American Heart Association.
