Tracking Cardiac Rehabilitation Utilization in Medicare Beneficiaries: 2017 UPDATE

Area of Science:

• Cardiology
• Public Health
• Health Services Research

Background:

• Cardiac rehabilitation (CR) is a Class I guideline-recommended therapy for patients with CR-eligible events.
• Understanding CR utilization patterns in Medicare beneficiaries is crucial for improving cardiovascular care.
• Previous data on CR utilization may not reflect current trends in a large, representative population.

Purpose of the Study:

• To update cardiac rehabilitation (CR) utilization data in a cohort of Medicare beneficiaries hospitalized for CR-eligible events in 2017.
• To stratify CR utilization by patient demographics and state of residence.
• To assess CR participation, engagement, and completion rates.

Main Methods:

• Identified Medicare fee-for-service beneficiaries with a CR-eligible event in 2017.
• Assessed CR participation (≥1 session) and completion (≥36 sessions) within 365 days post-discharge.
• Stratified measures by beneficiary characteristics, state of residence, and qualifying event type (primary and secondary).

Main Results:

• In 2017, 412,080 Medicare beneficiaries had a primary CR-eligible event; 28.6% completed ≥1 CR session.
• Among those attending CR, the mean number of sessions was 25 ± 12, with 27.6% completing ≥36 sessions.
• Nebraska reported the highest enrollment rate (56.1%), while 23 states fell below the national average.

Conclusions:

• Absolute enrollment, engagement, and completion rates for CR remain low among Medicare beneficiaries.
• A significant number of patients do not benefit from this guideline-recommended therapy.
• Additional research and widespread adoption of successful enrollment/engagement initiatives are necessary, particularly for identified at-risk populations.