HealthDay News — Although cardiac rehabilitation (CR) rates increased after Medicare expansion of CR coverage to include heart failure with reduced ejection fraction (HFrEF), the rates of use are still low, according to a study presented at the AHA Quality of Care and Outcomes Research Scientific Sessions 2021, held virtually on Nov. 15 in conjunction with the American Heart Association Scientific Sessions 2021.
Vinay Guduguntla, M.D., from the University of California San Francisco, and colleagues examined the impact of Medicare expansion of coverage for CR to include HFrEF patients in 2014. A 20 percent sample of Medicare claim files from 2008 to 2017 was used to identify 849,054 patients with HFrEF. CR participation was identified, and annual changes in use were compared in the prepolicy (2008 to 2013) and postpolicy (2014 to 2017) periods.
The researchers found that during the study period, 4.0 percent of beneficiaries with HFrEF attended CR. From 2008 to 2014, there was an increase in CR utilization, from 3.30 to 4.30 percent (absolute change, 0.15 percent per year). After Medicare expanded coverage, the rates of CR enrollment increased from 4.30 to 5.54 percent from 2014 to 2017 (annual absolute change, 0.31 percent). On an absolute scale, the annual rate of change in CR enrollment was 0.16 percent higher when comparing trends in participation before and after the change in policy.
“Future work should aim to identify and address all barriers to enrollment and find creative solutions to this complex problem,” Guduguntla said in a statement.