Rehabilitation practice patterns for patients with heart failure: the United States perspective

Many anticipate that the recent decision of the US Center for Medicare Services to expand cardiac rehabilitation (CR) reimbursement to include patients with systolic heart failure (HF) will lead to expanded application of exercise therapy for eligible HF patients. Nonetheless, US patterns of referral to and enrollment in CR for coronary heart disease have been notoriously poor, and such persistent under-enrollment suggests that there are entrenched obstacles that will impede the use of exercise therapy despite the new CR HF indication. However, application of CR for HF may still grow due to dynamic shifts in contemporary US health care.