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Scott Leezer, Director of Government Affairs Scott Leezer, Director of Government Affairs

Scott Leezer, Director of Government Affairs - PowerPoint Presentation

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Scott Leezer, Director of Government Affairs - PPT Presentation

The Federal Group Inc Expanding Access to Cardiac Rehab 2 Expanding Access to Cardiac Rehab Welcome Where are people calling in from today Type your first name and city and state into the chat box ID: 691745

rehabilitation cardiac access rehab cardiac rehabilitation rehab access expanding patients incentive benefits payments physician program heart miles requirement 488

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Presentation Transcript

Slide1

Scott Leezer, Director of Government Affairs

The Federal Group, Inc.

Expanding Access to Cardiac RehabSlide2

2

Expanding Access to Cardiac Rehab

Welcome

Where are people calling in from today?

Type your first name and city and state into the chat box.Slide3

3

Expanding Access to Cardiac Rehab

Welcome

Did you enrolled in a cardiac rehabilitation program?

Yes

NoSlide4

4

Expanding Access to Cardiac Rehab

Welcome

How far did you have to travel for your cardiac rehabilitation program?

5 miles or less

6-15 miles

16-25 miles

More than 25 milesSlide5

Cardiac rehabilitation is an exercise and education program that helps improve the health and well-being of people who have heart problems.

Cardiac rehab helps patients recover more quickly, return to an active lifestyle, and reduces the risk of a future cardiac event.

Recommended for patients following heart attack, angioplasty, open heart surgery, chronic chest pain, and heart failure.

5

Promote, Ensure Access to, and Expand

the Use of Cardiac Rehabilitation

Expanding Access to Cardiac RehabSlide6

CMS’ “Direct Supervision” Requirement &

S.488/HR 3355

Benefits of Cardiac Rehabilitation

Proposed Incentive Payments for Cardiac Rehabilitation Services Provided to Medicare BeneficiariesSlide7

7

Expanding Access to Cardiac Rehab

Reduced all-cause mortality

Improved adherence with preventive medications

Improved function and exercise capacity

Improved mood and quality of life

The Benefits of Cardiac RehabilitationSlide8

8

Expanding Access to Cardiac Rehab

The Benefits of Cardiac Rehabilitation

Reduced readmission rates to hospital by up to 25 percent

Reduced cardiac mortality from by up to 31 percent

Strong correlation between the number of cardiac rehabilitation sessions and improved long-term outcomesSlide9

9

Expanding Access to Cardiac Rehab

The Benefits of Cardiac Rehabilitation

What percentage of eligible patients enroll

in a cardiac rehab program?

80%

60%

40%

20%Slide10

10

Expanding Access to Cardiac Rehab

The Benefits of Cardiac Rehabilitation

Despite the benefits of cardiac rehabilitation, patients often don’t enroll. It is estimated that among eligible patients,

only one in five enroll

in a cardiac rehab program.Slide11

11

Expanding Access to Cardiac Rehab

The Benefits of Cardiac Rehabilitation

The barriers to cardiac rehabilitation include:

Lack of referral by cardiologists.

Scarcity of programs in rural and medically underserved areas.

Lack of coverage by insurance providers.

High out-of-pocket costs for patients.Slide12

12

Expanding Access to Cardiac Rehab

The Benefits of Cardiac Rehabilitation

Can you think of any additional barriers to enrolling in a cardiac rehabilitation program?Slide13

13

Expanding Access to Cardiac Rehab

Current law requires “direct physician supervision”, which requires a physician to be immediately available for each session.

This creates a more stringent requirement for physician supervision in cardiac rehabilitation than they do on the staffing of emergency rooms.

The physician requirement makes it difficult to operate cardiac rehab programs in rural areas were physicians are scare.

It also imposes unnecessary costs on programs and patients.

“Direct Supervision” RequirementSlide14

14

Expanding Access to Cardiac Rehab

Under proposed legislation (S. 488/H.R. 3355), non-physician providers; such as physician assistants, nurse practitioners, and clinical nurse specialists, would be able to supervise cardiac rehabilitation programs.

Senators Chuck Schumer (D-NY) and Mike Crapo (R-ID) and Representatives Lynn Jenkins (R-KS) and John Lewis (D-GA)

There are 26 Senate Cosponsors and 63 House Cosponsors

The Legislative Fix (

S. 488/H.R. 3355)Slide15

15

Expanding Access to Cardiac Rehab

In July 2016, the Centers for Medicare and Medicaid (CMS) proposed incentive payments to encourage the use of cardiac rehabilitation for Medicare beneficiaries.

To encourage doctors to refer more patients to cardiac rehabilitation, Medicare would pay an additional $25 per session for the first 11 sessions and an additional $175 per session thereafter.

Incentive Payments for Cardiac RehabilitationSlide16

16

Expanding Access to Cardiac Rehab

Incentive Payments for Cardiac Rehabilitation

But, does it go far enough?

The incentive payments would only apply to patients who have had a heart attack or coronary artery bypass surgery.

They would initially only be available in 90 geographic areas.

Is $25 sufficient for incentivizing referral?Slide17

17

Expanding Access to Cardiac Rehab

Incentive Payments for Cardiac Rehabilitation

Last month, Mended Hearts Inc. submitted comments to the CMS in support of the Cardiac Rehabilitation Incentive Payment Model

The comments highlighted the importance of cardiac rehab to our members and cardiovascular patients.

They encouraged CMS to continue to promote the use of cardiac rehabilitation and reduce barriers of enrollment for

beneficiaries

.

The comments supported the incentive payments and called for their broad implementation. Slide18

Active support for S.488/H.R. 3355 to allow non-physician providers to supervise cardiac rehab

Partnership with American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR)

Continually monitoring the proposed incentive payment models for providers of cardiac rehabilitation & promote its broad implementation

What to Expect from Mended Hearts

on the Cardiac Rehab Issue in the FutureSlide19

Thank you! Any Questions?