TY - JOUR
T1 - Intensive Cardiac Rehabilitation Is Markedly Underutilized by Medicare Beneficiaries
T2 - RESULTS from A 2012-2016 NATIONAL SAMPLE
AU - Husaini, Mustafa
AU - Deych, Elena
AU - Racette, Susan B.
AU - Rich, Michael W.
AU - Joynt Maddox, Karen E.
AU - Peterson, Linda R.
N1 - Funding Information:
This project was supported by the Washington University Division of Cardiology Smith-Oliver Fund. Dr Racette receives support from the National Institutes of Health (R34 HL138253, R01 AG060499, R25 HL105400, U24 AG047121), and the Foundation for Barnes-Jewish Hospital. Not relevant to this project, Dr Rich receives support from the NIH (R01 AG060499) and the Foundation for Barnes-Jewish Hospital. Dr Joynt Maddox receives research support related to Medicare payment policy from the National Heart, Lung, and Blood Institute (R01 HL143421) and National Institute on Aging (R01 AG060935, R01 AG063759, and R21 AG065526), and previously did contract work for the US Department of Health and Human Services. Dr Peterson has stock holdings in Medtronic and Johnson and Johnson. Dr Peterson receives salary support from the National Institutes of Health (R34 HL138253, R01 AG060499-01), and the Foundation for Barnes-Jewish Hospital.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Purpose: Intensive cardiac rehabilitation (ICR) was developed to enhance traditional cardiac rehabilitation (CR) by adding sessions focused on nutrition, lifestyle behaviors, and stress management. Intensive CR has been Medicare-approved since 2010, yet little is known about national utilization rates of ICR in the Medicare population or characteristics associated with its use. Methods: A 5% sample of Medicare claims data from 2012 to 2016 was used to identify beneficiaries with a qualifying indication for ICR/CR and to quantify utilization of ICR or CR within 1 yr of the qualifying diagnosis. Results: From 2012 to 2015, there were 107 246 patients with a qualifying indication. Overall, only 0.1% of qualifying patients participated in ICR and 16.2% in CR from 2012 to 2016, though utilization rates of both ICR and CR increased during this period (ICR 0.06 to 0.17%, CR 14.3 to 18.2%). The number of ICR centers increased from 15 to 50 over the same period. There were no differences between ICR and CR enrollees with respect to age, sex, race, discharge location, median income, dual enrollment, or number of comorbidities. Compared with eligible beneficiaries who did not attend ICR or CR, those who attended either program were younger, more likely to be male and White, and had higher median income. Conclusions: Although ICR and CR have a class 1 indication for the treatment of cardiovascular disease and the number of ICR centers has increased, ICR is not widely available and remains markedly underutilized. Continued research is needed to understand the barriers to program development and patient participation.
AB - Purpose: Intensive cardiac rehabilitation (ICR) was developed to enhance traditional cardiac rehabilitation (CR) by adding sessions focused on nutrition, lifestyle behaviors, and stress management. Intensive CR has been Medicare-approved since 2010, yet little is known about national utilization rates of ICR in the Medicare population or characteristics associated with its use. Methods: A 5% sample of Medicare claims data from 2012 to 2016 was used to identify beneficiaries with a qualifying indication for ICR/CR and to quantify utilization of ICR or CR within 1 yr of the qualifying diagnosis. Results: From 2012 to 2015, there were 107 246 patients with a qualifying indication. Overall, only 0.1% of qualifying patients participated in ICR and 16.2% in CR from 2012 to 2016, though utilization rates of both ICR and CR increased during this period (ICR 0.06 to 0.17%, CR 14.3 to 18.2%). The number of ICR centers increased from 15 to 50 over the same period. There were no differences between ICR and CR enrollees with respect to age, sex, race, discharge location, median income, dual enrollment, or number of comorbidities. Compared with eligible beneficiaries who did not attend ICR or CR, those who attended either program were younger, more likely to be male and White, and had higher median income. Conclusions: Although ICR and CR have a class 1 indication for the treatment of cardiovascular disease and the number of ICR centers has increased, ICR is not widely available and remains markedly underutilized. Continued research is needed to understand the barriers to program development and patient participation.
KW - Medicare
KW - cardiac rehabilitation
KW - intensive cardiac rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=85129781626&partnerID=8YFLogxK
U2 - 10.1097/HCR.0000000000000632
DO - 10.1097/HCR.0000000000000632
M3 - Article
C2 - 34508035
AN - SCOPUS:85129781626
SN - 1932-7501
VL - 42
SP - 156
EP - 162
JO - Journal of Cardiopulmonary Rehabilitation and Prevention
JF - Journal of Cardiopulmonary Rehabilitation and Prevention
IS - 3
ER -