A comprehensive set of performance and quality measures for patients who are eligible to participate in cardiac rehabilitation (rehab) were released by the ACC and American Heart Association, in collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation, on March 29 in the Journal of the American College of Cardiology.

The new measure set includes six performance measures and three quality measures, and updates the original measure set released in 2007 and the 2010 focused update. They build upon recent evidence-based clinical practice guidelines and scientific statements, and include feedback from peer review and public comments.

The performance measures – which target meaningful gaps in the quality of care and are typically based on Class I clinical practice guidelines – span the inpatient and outpatient care setting and the facility level and provider level to measure communication and care coordination as well as effective clinical care. They include: Cardiac Rehab Patient Referral From an Inpatient Setting; Exercise Training Referral for Heart Failure (HF) From Inpatient Setting; Cardiac Rehab Patient Referral From an Outpatient Setting; Exercise Training Referral for HF From Outpatient Setting; Cardiac Rehab Enrollment–Claims Based; and Cardiac Referral Enrollment–Registry/Electronic Health Records Based.

New measures that may be useful but are not based on Class I clinical practice guidelines are included as quality measures. These include Cardiac Rehab Time to Enrollment; Cardiac Rehab Adherence (≥ 36 sessions); and Cardiac Rehab Communication: Patient Enrollment, Adherence, and Clinical Outcomes.

According to the writing committee, “[The] implementation of this measure set by health care systems, health care providers, health insurance carriers, chronic disease management organizations, cardiac rehab programs, and other groups who have responsibility for the delivery of care to persons with cardiovascular disease will enhance the structure, process, and outcomes of care provided to patients who are eligible for cardiac rehab services.”

“This update of cardiac rehab performance measures builds on the previous 2010 cardiac rehab referral measures by adding measures dealing with enrollment in and adherence to a cardiac rehab program, as well as the coordination of care,” explains Randal J. Thomas, MD, MS, FACC, chair of the writing committee.

Moving forward, the authors explain that the new measures “will need to be tested and validated over time.” They also suggest additional areas for future research “that will potentially have an impact on cardiac rehab performance and quality measures.”

Keywords: Acute Coronary Syndrome, Atrial Fibrillation, Cardiology, Coronary Artery Bypass, Exercise, Heart Failure, Insurance Coverage, Motor Activity, Myocardial Infarction, Patient Compliance, Patient Discharge, Patient Preference, Patient Readmission, Percutaneous Coronary Intervention, Peripheral Arterial Disease, Primary Prevention, Quality Improvement, Quality of Life, Rehabilitation, Referral and Consultation, Secondary Prevention, Standard of Care, Stroke, Stroke Volume, Telemedicine

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