Background on the issues
Heart disease is the leading cause of death and costs
40% of US will have heart disease by 2030
$215 billion/yr = 1 in 6 healthcare dollars
Costs will rise by 4X by 2030 unless something is done
Lung conditions are right behind these numbers, and COVID-19 has increased the number of pulmonary cases.
Definitions: Cardiac and Pulmonary Rehabilitation
Medicare covers these rehabilitation programs because they are safe and effective treatments.
2022 MedPAC Report requested Congress to increase access to care for medically underserved Medicare beneficiaries.
Cardiac Rehabilitation (CR): Programs that are conducted after a heart attack, stent, cardiac surgery, or other cardiac conditions and include supervised exercise, education, and counseling.
Intensive Cardiac Rehabilitation (ICR): A more intensive form of cardiac rehabilitation. The greater intensity has been proven to reverse the progression of coronary heart disease.
Pulmonary Rehabilitation: Programs that provide education and exercises for people with lung diseases to help them better manage their conditions.
Venues of Care: Current rehabilitation programs primarily take place in outpatient facilities of health systems/hospitals. The programs also take place in physician offices.
Cardiac and Pulmonary Rehabilitation are proven to work - but are underused
Class 1 recommendation (highest level) & 35 years of evidence
Cardiac rehab has been shown to:
Increase life expectancy by five years and reduce mortality by 40+%
Reduce hospital readmissions by 30-40% (this is where the costs are)
HOWEVER, only 24% of eligible patients start, and 8% complete a program.
Well below the 70% goal that CDC has set (Million Hearts Initiative)
What’s the Problem?
Barriers are long travel distances, hospital parking, limited facility hours, and facility waitlists.
There is physical space across the U.S. for only 45% of eligible patients to attend.
Some facilities are closing due to financial challenges and staffing issues.
What action do we need to take?
We need to give people more options for heart or lung rehabilitation.
Facility-based programs work for some, but not all.
This is about options and access for Medicare beneficiaries.
Virtual rehabilitation in the home has worked, as shown during the PHE.
Health systems and doctors’ offices need the option to add virtual rehab permanently to give access back to our heart and lung patients.
This legislation improves the lives of Medicare beneficiaries and decreases the cost of care:
Enabling patients to choose the best venue for them. Cardiac, lung, and Long-COVID patients need these options.
Expands the number of Medicare beneficiaries who can benefit from these vital therapies by eliminating the need to travel for services.
Decreasing hospital admissions and overall cost of care by broadening the number of beneficiaries who seek and complete these effective programs.