Only one in four Medicare recipients undergo cardiac rehabilitation following a heart attack or other heart-related health event, a study has found.
In research published Tuesday
in the journal Circulation: Cardiovascular Quality and Outcomes, researchers found that about 25 percent of Medicare beneficiaries participate in a cardiac rehabilitation program.
Of those who did, only 24 percent initiated the program within 21 days of the acute cardiac event or surgery, and only 27 percent completed the full course of the recommended 36 or more cardiac rehabilitation sessions, which have been shown to improve health outcomes.
An estimated 1.3 million U.S. adults with heart disease may qualify for cardiac rehabilitation annually. The care program has been shown to improve health outcomes among patients who have heart failure, have suffered heart attacks or have undergone a cardiac procedure such as coronary artery bypass surgery.
“The low participation and completion rates observed translate to upwards of 7 million missed opportunities in this study to potentially improve health outcomes if 70 percent of those covered by Medicare who had a heart attack or acute heart event or surgery participated in cardiac rehabilitation and completed 36 sessions,” lead study author Matthew D. Ritchey, a researcher at the Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention, said in a statement.
In their observational study, Ritchey and his colleagues reviewed the records of more than 366,000 patients covered by Medicare who were eligible for outpatient cardiac rehabilitation in 2016.
In addition to the low overall participation figures, they found that participation in outpatient cardiac rehabilitation decreased with increasing age, with only about 10 percent of those 85 years of age and older receiving the service, compared to 32 percent among those between 65 and 74 years of age.
Participation was also lower among women than men — approximately 19 percent versus approximately 29 percent — while non-Hispanic whites had the highest participation rate at about 26 percent, versus 16 percent for Asians, 14 percent for non-Hispanic blacks and 13 percent for Hispanics.
Researchers noted that there are “systematic, logistical and cultural barriers” to attending and completing an outpatient cardiac rehabilitation program: Some may not be able to afford rehabilitation due to the costs or the time needed to participate in the program versus returning to work and other personal commitments.
In 2019, AHA published a scientific statement
that described the need for and benefits of home-based cardiac rehabilitation programs to improve patient access and health outcomes, outlining the range of health, care and cost benefits to patients.
“Cardiac rehabilitation has strong evidence demonstrating its lifesaving and life-enhancing benefits, and Medicare Part B provides coverage for the program,” Ritchey said.
Reporting by Brian P. Dunleavy
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