The CMS has selected 516 physician practices to take part in an experiment intended to change the way providers identify and manage cardiovascular disease.
The new CMS Innovation Center program—the Million Hearts Cardiovascular Disease Risk Reduction Model—will use predictive modeling to generate personalized risk scores and develop specific plans in partnership with patients to reduce the risk of having a heart attack or stroke.
The five-year pilot will employ a randomized controlled design to identify successful prevention and interventions. Practices in the control group—roughly half the participants—will not be asked to implement the risk calculation or evidence-based risk modification but will submit clinical data on eligible beneficiaries for comparison.
Participating practices will receive a one-time $10 per beneficiary payment to conduct the initial risk assessment. They will also receive $10 per beneficiary a month as they continue risk-mitigation care for beneficiaries with a high risk for heart disease.
“The idea around Million Hearts is to engage with the patient, not just with these individual risk factors but overall give them a sense of what their risk is of developing cardiovascular disease over the next 10 years,” said Dr. Paul Casale, executive director of New York QualityCare, an accountable care organization that includes New York-Presbyterian, Columbia University Medical Center and Weill Cornell Medicine. Columbia and Weill Cornell are participating—one in the control group and one in the intervention group.
“This broadens the conversation and gives a lot of context,” Casale said. “It's not just one or two risk factors.”
One in three deaths is caused by heart attack and stroke, resulting in more than $300 billion of healthcare costs a year, according to federal data.
“Our healthcare system historically often emphasized acute care over preventive care,” Dr. Patrick Conway, CMS acting principal deputy administrator and chief medical officer, said in a statement. “This initiative will enhance patient-centered care and give practitioners the resources to invest the time and in staff to address and manage patients who are at high risk for heart attacks and strokes.”