Participation in cardiac rehabilitation rose among Medicare recipients with heart failure following coverage expansion in 2014, but the numbers remain abysmally low at less than 10%, a new study has found.
More than 6 million American adults have heart failure, one of the top reasons for hospital admission for people 65 years of age or older. More than 70% of these adults are re-hospitalized or die within one year after hospital discharge, according to the American Heart Association. Prevalence of the condition is expected to increase by 46% by 2030.
But these patients’ enrollment in cardiac rehab increased from 4.30% to only 5.54% between 2014 and 2017, the years following the Centers for Medicare & Medicaid Services’ addition of the benefit, investigators found.
“Despite clear benefits of cardiac rehabilitation in preventing death, reducing hospitalizations and improving physical ability, cardiac rehabilitation is used by very few,” study co-author Vinay Guduguntla, M.D., of the University of California, San Francisco, said in a statement. “Based on the current data, more than 90% of people with heart failure will not receive a treatment that could improve their health and survival.”
CMS’s participation criteria may contribute to this lack of participation, according to Randal J. Thomas, M.D., of the Mayo Clinic Cardiac Rehabilitation Program in Rochester, MN, who was not involved in the study. Patients must wait at least six weeks after being hospitalized for heart failure to enroll in a rehab program, and studies show that any delays decrease participation rates and worsen outcomes, he said in an AHA release.
Insurance coverage may be one of many factors contributing to the lack of cardiac rehab participation, Guduguntla noted. “Future work should aim to identify and address all barriers to enrollment and find creative solutions to this complex problem,” he concluded.
