75% of eligible Medicare recipients do not participate in effective cardiac rehabilitation programs

New research demonstrates that less than 25% of eligible Medicare beneficiaries successfully participate in outpatient cardiac rehabilitation programs following incidence of a heart attack or acute heart event.

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New research demonstrates that over 75% of eligible Medicare beneficiaries do not participate in effective outpatient cardiac rehabilitation programs following incidence of a heart attack or acute heart event.

Approximately 1.3 million individuals in the USA with cardiovascular disease qualify for participation in outpatient cardiac rehabilitation programs; these have been proven effective at improving health outcomes of individuals with heart failure, who have suffered heart attacks or have undergone cardiac surgery.

In this study, researchers determined the participation, timely initiation and completion rates of 366,000 eligible individuals, covered by Medicare, for cardiac rehabilitation programs. Timely program start was defined as participant initiation within 21 days of their experiencing an adverse cardiovascular event or surgery.

Key study findings include the fact that only approximately 90,000 individuals – equivalent to 25% of the study population – participated in a cardiac rehabilitation program. Amongst these participants, only 24% initiated their program within 21 days of their cardiac event. Women, non-white individuals and participants over the age of 85 years where amongst those ranking the lowest cardiac rehabilitation program participation.

Further, successful completion of cardiac rehabilitation programs was observed to be as low as 27%, despite completion of the full 36 sessions of the programs being associated with improved health outcomes.

Lead study author Matthew Ritchey (Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention; GA, USA) stated: “Cardiac rehabilitation has strong evidence demonstrating its lifesaving and life-enhancing benefits, and Medicare Part B provides coverage for the program. However, participation in cardiac rehabilitation programs remains low among people covered by Medicare.”

Researchers noted that barriers towards successful initiation and completion of cardiac rehabilitation programs could range from systematic challenges, such as the lack of universally accepted, automated, electronic referral processes for cardiac rehabilitation services, to patient-personal challenges, including program time commitments.

Ritchey continued: “The low participation and completion rates observed translate to upwards of 7 million missed opportunities in this study to potentially improve health outcomes if 70% of them covered by Medicare who had a heart attack or acute heart event or surgery participated in cardiac rehabilitation and completed 36 sessions.”

“Improving awareness of the value of cardiac rehabilitation, increasing referral of eligible patients and reducing system and patient barriers to participation are all critical steps in improving the referral, enrollment and participation rates, which, in turn, can improve patient outcomes,” Ritchey concluded.


Ritchey MD, Maresh S, McNeely J et al. Tracking cardiac rehabilitation participation and completion among Medicare beneficiaries to inform the efforts of a national initiative. Circ-Cardiovasc Qual. doi:org/10.1161/CIRCOUTCOMES.119.005902 (2020) (Epub ahead of print);



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