Under a new population health program, CMS will pay providers to reduce the absolute risk for heart disease or stroke among high-risk Medicare beneficiaries.
With the help of 516 inaugural participating healthcare providers nationwide, federal officials are harnessing data to rise to a pair of crucial population health challenges: reducing rates of cardiovascular disease and stroke.
Launched on July 21, the Million Hearts Cardiovascular Disease Risk Reduction Model is a data-driven effort designed to reduce the risk of cardiovascular disease and stroke among Medicare beneficiaries, federal officials said in a statement.
Participating providers will work with Medicare beneficiaries individually "to identify the best approach or approaches to reducing their risk of having a heart attack or stroke." Factors that will be considered include smoking cessation interventions, blood pressure management, and the use of cholesterol-lowering drugs or aspirin.
"Each beneficiary will receive a personalized risk modification plan that will target their specific risk factors. Organizations in the intervention group will be paid for reducing the absolute risk for heart disease or stroke among their high-risk beneficiaries," according to CMS.
The Million Hearts Campaign aligns well with the population health goals at Danville, PA-based Geisinger Health System, says Sanjay Doddamani, MD, system director of advanced cardiac disease and heart failure.
"We have gone from Baby Boomers, to Generation X, to Millennials carrying modifiable risks for heart attacks and strokes. As a steward for healthcare in the communities we serve, we are interested to see that our communities are smoke-free, physically on the move, eating right, and controlling blood pressure and cholesterol and lipids by diet, exercise, and medications. The Million Hearts initiative aligns well with these goals," he says.
Cardiovascular disease and stroke are among the most deadly ailments in the country, according to a Centers for Medicare & Medicaid Services factsheet, that lists heart attacks and strokes as the first and fifth leading causes of death, and major contributors to disability, in the United States.
Identifying Medicare beneficiaries who are at highest risk for having a heart attack or stroke is a key goal of the Million Hearts initiative's risk stratification effort.
Risk is measured using age, race, cholesterol levels, systolic blood pressure, and the use of statins, antihypertensive medication, or aspirin therapy. Smoking history and diabetes status are also risk factors
"The Million Hearts CVD Risk Reduction Model is a randomized controlled trial that seeks to bridge a gap in cardiovascular care by providing targeted incentives for healthcare practitioners to engage in beneficiary CVD risk calculation and population-level risk management. Instead of focusing on the individual components of risk, participating organizations will engage in risk stratification across a beneficiary panel to identify those at highest risk.," according to CMS.
Payment Incentives for Providers
To help pay for the Million Hearts Risk Reduction Model, healthcare providers can earn per-member-per-month payments as high as $10 to help pay for the care management of high-risk cardiovascular disease patients.
Payment incentives are essential to help providers transition to value-based care, Doddamani says. "Providers and systems are often challenged in terms of resources to engage with the community to create awareness and improve understanding, especially in vulnerable groups where economic challenges are accompanied by smoking and poor dietary choices. Enhanced payments for better outcomes is a way of paying for value in healthcare."
Nearly 20,000 healthcare practitioners and more than 3 million Medicare beneficiaries are expected to participate in the five-year model between September 2016 and August 2021.
Christopher Cheney is the CMO editor at HealthLeaders.