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CMS model would reduce cardiovascular disease

Providers will have incentives to calculate risks of their Medicare patients.

The Centers for Medicare & Medicare Services is calling on doctors, hospitals and health professionals to participate in a new aspect of the federal government's Million Hearts program, a national initiative to prevent 1 million heart attacks and strokes between 2012 and 2017.

The Centers for Medicare & Medicare Services is calling on doctors, hospitals and health professionals to participate in a new aspect of the federal government’s Million Hearts program, a national initiative to prevent 1 million heart attacks and strokes between 2012 and 2017.

This program seeks to rope the medical community into cardiovascular disease reduction. Amid many other efforts to tackle prevention, through accountable care organizations and community-based care, CMS is asking providers to help “design sustainable models of care that help reduce 10-year atherosclerotic cardiovascular disease risk (ASCVD) and prevent heart attacks and strokes for tens of thousands of eligible Medicare beneficiaries.”

Currently, Medicare pays providers when to meet specific blood pressure, cholesterol, and other cardiovascular targets in their patients. The new approach, what the agency has termed the CVD Risk Reduction Model, will try to build on that and use it by leveraging technology to see what works best. It will include a randomized-controlled trial and use a “data-driven, widely-accepted predictive modeling approach to generate individualized risk scores and mitigation plans for patients.”

The randomized-controlled trial aspect seeks to “bridge a gap in cardiovascular care by providing targeted incentives for providers to engage in beneficiary CVD risk calculation and population-level risk management,” the agency said. “Instead of focusing on the individual components of risk, participating practices will engage in risk stratification across a patient panel to identify those at highest risk for ASCVD.”

Providers will have incentives to calculate risks of their Medicare patients using the American College of Cardiology and American Heart Association’s 10-year cohort risk, and to take that information to create risk modification plans in concert with patients.

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The framework for the program revolves around universal risk stratification of all eligible Medicare beneficiaries, evidenced-based risk modification using shared decision, prevention and population health management strategies, and reporting of continuous risk calculator variables, ASCVD 10-year risk score, and a cardiovascular Physician Quality Reporting System. Participating medical practices will also have the option of reporting on additional PQRS measures within the data registry to meet both the PQRS and Value-Based Modifier reporting requirements.

CMS said that it is seeking “a diverse range of practices varying in size, patient case mix, and other patient demographic factors.” Approximately 360 intervention and 360 control group practices will be selected from the final pool of eligible applicants. Here are agency’s links for letters of intent and applications. The deadline for letters of intent is September 10, 2015.

Twitter: @AnthonyBrino