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Making strides in heart disease prevention

In July, CMS announced it has selected 516 health care organizations to participate in the Million Hearts® CVD Risk Reduction Model. The model is a randomized, controlled trial that provides targeted incentives for clinicians to engage in beneficiary cardiovascular disease (CVD) risk calculation and population-level risk management. The model aims to focus on the individual components of CVD risk. Participating organizations will engage in risk stratification across a beneficiary panel to identify those at highest risk for atherosclerotic cardiovascular disease (ASCVD), and ultimately, strive to prevent heart attacks and strokes for tens of thousands of eligible Medicare beneficiaries.

CMS and the US Centers for Disease Control and Prevention (CDC) launched the Million Hearts campaign in 2012 and set the goal of preventing one million heart attacks and strokes by 2017. The early years of the campaign focused on encouraging a targeted focus on the “ABCS” – Aspirin for people at risk, Blood pressure control, Cholesterol management, and Smoking cessation–which address the major risk factors for cardiovascular disease and can help to prevent heart attacks and strokes. Through a series of challenges, the campaign engaged private and public partners across the health care system.

This latest Risk Reduction Model comes out of the CMS Centers for Medicare and Medicaid Innovation. In the pilot, physicians will use predictive modeling to identify patients at risk of developing cardiovascular disease, using health data to assign individual risk scores and design intervention plans. Physicians will measure risk 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 pilot will run for five years, and CMS is aiming to involve approximately 20,000 clinicians, including practitioners from general practice, internal medicine, and geriatrics, along with 3.3 million Medicare FFS beneficiaries.

Analysis: The model is innovative because it is aims to lower CVD risks across the population. Currently, health care practitioners are paid to screen for blood pressure, cholesterol, or other risk factors individually. This approach, however, will use data-driven predictive modeling approaches to generate individual risk scores and mitigation plans for eligible Medicare FFS beneficiaries. As part of the Risk Reduction Model, health care providers can earn per-member-per-month payments to help pay for the care management of high-risk cardiovascular disease patients.

CMS, “Medicare announces participants for a new initiative to prevent heart attacks and strokes,” July 21, 2016

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Author bio

Doug leads Deloitte Consulting LLP’s Life Sciences and Health Care practice. With 24 years of experience, he works closely with multiple top health care organizations on major clinical and enterprise transformation efforts and on large-scale technology implementation projects. Doug has extensive experience in comprehensive quality and patient safety transformations, turnaround and performance improvement in academic medical centers as well as organization/workflow redesign and technology enablement. He has served as the lead on a number of enterprise transformation initiatives with some of Deloitte’s most largest and most complex clients.