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New CMS Initiative will Leverage Predictive Modeling to Prevent Heart Attacks and Strokes

July 22, 2016
by Rajiv Leventhal
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A new program released by the Centers for Medicare & Medicaid Services (CMS) will aim to decrease cardiovascular disease risk by leveraging data analytics by assessing an individual patient’s risk for heart attack or stroke and applying prevention interventions.

Practitioners participating in the Million Hearts Cardiovascular Disease Risk Reduction Model’s intervention group will use a data-driven, predictive modeling approach to generate personalized risk scores and develop specific plans in partnership with patients to reduce the risk of having a heart attack or stroke, CMS said.

According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death and a major contributor to disability in the U.S. One in three deaths are caused by heart attacks and strokes, resulting in over $300 billion of healthcare costs each year. Currently, practitioners are paid to screen for blood pressure, cholesterol, or other risk factors individually.

But with this new model, a new approach will be tested. Nearly 20,000 healthcare practitioners and over 3.3 million Medicare fee-for-service beneficiaries will participate in the five-year model. For the program, CMS announced 516 awardees in 47 states, Puerto Rico, and the District of Columbia.

Practitioners in the intervention group will work with beneficiaries individually to identify the best approach or approaches to reducing their risk of having a heart attack or stroke – for example, smoking cessation interventions, blood pressure management, or cholesterol-lowering drugs or aspirin – and will explain the benefits of each approach. Each beneficiary will receive a personalized risk modification plan that will target their specific risk factors. Organizations in the intervention group will be paid for reducing the absolute risk for heart disease or stroke among their high-risk beneficiaries, the agency said.

This model is part of Million Hearts, a broad national initiative co-led by CMS and CDC to prevent one million heart attacks and strokes by 2017.

“Our healthcare system historically often emphasized acute care over preventive care,” Patrick Conway, M.D., 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.”

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