Tracking Cardiac Rehabilitation Utilization in Medicare Beneficiaries: 2017 UPDATE.

Keteyian SJ, Jackson SL, Chang A, Brawner CA, Wall HK, Forman DE, Sukul D, Ritchey MD, Sperling LS. Tracking Cardiac Rehabilitation Utilization in Medicare Beneficiaries: 2017 UPDATE. Journal of cardiopulmonary rehabilitation and prevention. 2022 Jul 1; 42(4):235-245.

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Abstract:

PURPOSE: This study updates cardiac rehabilitation (CR) utilization data in a cohort of Medicare beneficiaries hospitalized for CR-eligible events in 2017, including stratification by select patient demographics and state of residence. METHODS: We identified Medicare fee-for-service beneficiaries who experienced a CR-eligible event and assessed their CR participation ( = 1 CR sessions in 365 d), engagement, and completion ( = 36 sessions) rates through September 7, 2019. Measures were assessed overall, by beneficiary characteristics and state of residence, and by primary (myocardial infarction; coronary artery bypass surgery; heart valve repair/replacement; percutaneous coronary intervention; or heart/heart-lung transplant) and secondary (angina; heart failure) qualifying event type. RESULTS: In 2017, 412 080 Medicare beneficiaries had a primary CR-eligible event and 28.6% completed = 1 session of CR within 365 d after discharge from a qualifying event. Among beneficiaries who completed = 1 CR session, the mean total number of sessions was 25 ± 12 and 27.6% completed = 36 sessions. Nebraska had the highest enrollment rate (56.1%), with four other states also achieving an enrollment rate > 50% and 23 states falling below the overall rate for the United States. CONCLUSIONS: The absolute enrollment, engagement, and program completion rates remain low among Medicare beneficiaries, indicating that many patients did not benefit or fully benefit from a class I guideline-recommended therapy. Additional research and continued widespread adoption of successful enrollment and engagement initiatives are needed, especially among identified populations.