The Federal Group Inc Expanding Access to Cardiac Rehab 2 Expanding Access to Cardiac Rehab Welcome Where are people calling in from today Type your first name and city and state into the chat box ID: 691744
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Scott Leezer, Director of Government Affairs
The Federal Group, Inc.
Expanding Access to Cardiac RehabSlide2
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Expanding Access to Cardiac Rehab
Welcome
Where are people calling in from today?
Type your first name and city and state into the chat box.Slide3
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Expanding Access to Cardiac Rehab
Welcome
Did you enrolled in a cardiac rehabilitation program?
Yes
NoSlide4
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Expanding Access to Cardiac Rehab
Welcome
How far did you have to travel for your cardiac rehabilitation program?
5 miles or less
6-15 miles
16-25 miles
More than 25 milesSlide5
Cardiac rehabilitation is an exercise and education program that helps improve the health and well-being of people who have heart problems.
Cardiac rehab helps patients recover more quickly, return to an active lifestyle, and reduces the risk of a future cardiac event.
Recommended for patients following heart attack, angioplasty, open heart surgery, chronic chest pain, and heart failure.
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Promote, Ensure Access to, and Expand
the Use of Cardiac Rehabilitation
Expanding Access to Cardiac RehabSlide6
CMS’ “Direct Supervision” Requirement &
S.488/HR 3355
Benefits of Cardiac Rehabilitation
Proposed Incentive Payments for Cardiac Rehabilitation Services Provided to Medicare BeneficiariesSlide7
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Expanding Access to Cardiac Rehab
Reduced all-cause mortality
Improved adherence with preventive medications
Improved function and exercise capacity
Improved mood and quality of life
The Benefits of Cardiac RehabilitationSlide8
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Expanding Access to Cardiac Rehab
The Benefits of Cardiac Rehabilitation
Reduced readmission rates to hospital by up to 25 percent
Reduced cardiac mortality from by up to 31 percent
Strong correlation between the number of cardiac rehabilitation sessions and improved long-term outcomesSlide9
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Expanding Access to Cardiac Rehab
The Benefits of Cardiac Rehabilitation
What percentage of eligible patients enroll
in a cardiac rehab program?
80%
60%
40%
20%Slide10
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Expanding Access to Cardiac Rehab
The Benefits of Cardiac Rehabilitation
Despite the benefits of cardiac rehabilitation, patients often don’t enroll. It is estimated that among eligible patients,
only one in five enroll
in a cardiac rehab program.Slide11
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Expanding Access to Cardiac Rehab
The Benefits of Cardiac Rehabilitation
The barriers to cardiac rehabilitation include:
Lack of referral by cardiologists.
Scarcity of programs in rural and medically underserved areas.
Lack of coverage by insurance providers.
High out-of-pocket costs for patients.Slide12
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Expanding Access to Cardiac Rehab
The Benefits of Cardiac Rehabilitation
Can you think of any additional barriers to enrolling in a cardiac rehabilitation program?Slide13
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Expanding Access to Cardiac Rehab
Current law requires “direct physician supervision”, which requires a physician to be immediately available for each session.
This creates a more stringent requirement for physician supervision in cardiac rehabilitation than they do on the staffing of emergency rooms.
The physician requirement makes it difficult to operate cardiac rehab programs in rural areas were physicians are scare.
It also imposes unnecessary costs on programs and patients.
“Direct Supervision” RequirementSlide14
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Expanding Access to Cardiac Rehab
Under proposed legislation (S. 488/H.R. 3355), non-physician providers; such as physician assistants, nurse practitioners, and clinical nurse specialists, would be able to supervise cardiac rehabilitation programs.
Senators Chuck Schumer (D-NY) and Mike Crapo (R-ID) and Representatives Lynn Jenkins (R-KS) and John Lewis (D-GA)
There are 26 Senate Cosponsors and 63 House Cosponsors
The Legislative Fix (
S. 488/H.R. 3355)Slide15
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Expanding Access to Cardiac Rehab
In July 2016, the Centers for Medicare and Medicaid (CMS) proposed incentive payments to encourage the use of cardiac rehabilitation for Medicare beneficiaries.
To encourage doctors to refer more patients to cardiac rehabilitation, Medicare would pay an additional $25 per session for the first 11 sessions and an additional $175 per session thereafter.
Incentive Payments for Cardiac RehabilitationSlide16
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Expanding Access to Cardiac Rehab
Incentive Payments for Cardiac Rehabilitation
But, does it go far enough?
The incentive payments would only apply to patients who have had a heart attack or coronary artery bypass surgery.
They would initially only be available in 90 geographic areas.
Is $25 sufficient for incentivizing referral?Slide17
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Expanding Access to Cardiac Rehab
Incentive Payments for Cardiac Rehabilitation
Last month, Mended Hearts Inc. submitted comments to the CMS in support of the Cardiac Rehabilitation Incentive Payment Model
The comments highlighted the importance of cardiac rehab to our members and cardiovascular patients.
They encouraged CMS to continue to promote the use of cardiac rehabilitation and reduce barriers of enrollment for
beneficiaries
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The comments supported the incentive payments and called for their broad implementation. Slide18
Active support for S.488/H.R. 3355 to allow non-physician providers to supervise cardiac rehab
Partnership with American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR)
Continually monitoring the proposed incentive payment models for providers of cardiac rehabilitation & promote its broad implementation
What to Expect from Mended Hearts
on the Cardiac Rehab Issue in the FutureSlide19
Thank you! Any Questions?