Today, the Centers for Medicare and Medicaid Services (CMS) announced organizations selected to participate in the Million Hearts Cardiovascular Disease Risk Reduction Model. This marks the first formal public notification of participants since the model was initially announced in May of 2015. The model supports the Million Hearts campaign, an initiative that has garnered support from the ACC due to the campaign’s ultimate goal of preventing one million heart attacks and strokes by 2017.

Currently, clinicians are paid for individual screenings of various risk factors which does not take into account overall population-level risk management. The Million Hearts Cardiovascular Disease Risk Reduction model is innovative in that it is a randomized controlled trial using predictive modeling that stratifies risk across an entire beneficiary population to identify those at highest risk for atherosclerotic cardiovascular disease (ASCVD). This will ultimately be used to generate individualized risk scores and mitigation plans. 

A little over  500 organizations, were selected out of over 750 applicants to participate in this five-year model. The selected organizations represent over 20,000 health care practitioners across 47 states that care for over 3.3 million Medicare fee-for-service beneficiaries. The selected organizations were randomly divided into a fairly equal amount of intervention and control groups, 260 and 256 organizations respectively.

The intervention groups are required to use the ACC/American Heart Association ASCVD Risk Estimator for universal risk stratification of all eligible Medicare fee-for-service beneficiaries. The risk calculator stratifies risk based on age, race, total and high-density lipoprotein cholesterol levels, low-density lipoprotein cholesterol, systolic blood pressure, use of statin therapy, antihypertensive medication, use of aspirin therapy, smoking status and diabetes status.

The intervention groups must also use evidenced-based risk modification which emphasized shared decision making and team-based care management, and use risk stratification to identify and implement effective prevention and population health management strategies. Lastly, the intervention groups are required to and report continuous risk calculator variables and ASCVD ten-year risk score for each beneficiary through a data registry provided by the Centers for Medicare & Medicaid Innovation Center. The control groups are asked to submit clinical data on all Medicare fee-for-service beneficiaries to compare with the intervention groups.

To learn more about the Million Hearts Cardiovascular Disease Risk Reduction Model, click here.

More information on how the program works [PDF]

Keywords: American Heart Association, Antihypertensive Agents, Aspirin, Blood Pressure, Centers for Medicare and Medicaid Services, U.S., Cholesterol, LDL, Control Groups, Decision Making, Diabetes Mellitus, Fee-for-Service Plans, Goals, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Lipoproteins, HDL, Medicaid, Medicare, Motivation, Myocardial Infarction, Registries, Risk Factors, Risk Management, Risk Reduction Behavior, Smoking, Stroke, United States

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