A Million Hearts Set Out to Reduce Cardiovascular Disease
By Sarianne Gruber
The deadline is quickly approaching. All interested medical practices can be a part of the Million Hearts Study as long as an application is submitted by September 10, 2015 11:59pm (EDT). This is an excellent opportunity to join a randomized-controlled trial to uncover the best care delivery models that can potentially reduce cardiovascular risk. Why all the excitement? The Million Hearts® (@MillionHeartsUS) initiative is to prevent one million heart attacks and strokes and the Centers of Medicare and Medicaid Services (CMS) goal is to build and use better models of care and payment. Together they are currently seeking to enroll 720 practices with eligible patients for the models. As a randomized-control trial, half of the practices would be selected as the interventions group and the other half as the control group.
About the Study
- The intervention group will screen all eligible Medicare beneficiaries for their 10 year risk of a heart attack or stroke.
- Risk will be measured using an ACC/AHA ASCVD pooled risk calculator, which includes but is not limited to the following pieces of data: age, gender, blood pressure, cholesterol level, smoking status.
- Each patient is assigned a 10-year-risk percentage.
- The highest risk patients, who have a risk of over 30% of heart attack or stroke over 10 years), their providers will receive a monthly per beneficiary Cardiovascular Care Management payment to reduce their practice wide absolute.
- No blood pressure or cholesterol targets would be used, just shared decision making. The reward will be driven on reducing the predicted cardiac risk.
- All enrolled practices have the option to calculate and track risk on their own or use the free web-based tool.
- The control group will report clinical data (such as age, cholesterol level, and select information on their attributed Medicare Beneficiaries at years 1, 2, 3 and 5 of the model. They will receive a payment of $20 per beneficiary payment for each reporting cycle.
- The payment and care delivery models for Million Hearts®: Cardiovascular Disease (CVD) Risk Reduction Model will be tested over a 5-year period, starting in January 2016 and ending December 2020.
- All practices are recommended to create their own innovative care delivery model to reduce 10 year ASCVD risk to prevent heart attacks and strokes.
- The following delivery elements must be incorporated in the proposed model.
- Risk Stratified Care
- Population Health Management
- Shared Decision Making
- Individual Risk Modification Planning
- Team-Based Care
- Quality and Clinical Data Reporting
- The target population for the CVD model are Medicare FFS beneficiaries aged 18-79 years of age, and must meet the inclusion criteria to be risk-stratified using the ACC/AHA CVD risk calculator.
- The risk calculator uses the following variables: age, race, total and high-density lipoprotein (HDL) cholesterol levels, systolic blood pressure, use of antihypertensive medication, smoking status and diabetes status.