Abstract 15035: Regional Variation in the Availability and Utilization of Cardiac Rehabilitation Services Among Eligible Medicare Fee-for-Service Beneficiaries: Where Are the Opportunities for Improvement?
Introduction: Use of cardiac rehabilitation (CR) can save lives, improve health, and reduce health care costs, yet utilization remains low. The Million Hearts CR Collaborative aims to increase referrals to, participation in, and sustainability of CR programs. This study seeks to identify geographic variation in eligibility, access, and utilization of CR services among Medicare fee-for-service (FFS) beneficiaries.
Methods: We used Medicare FFS administrative data from 2013-2014 to identify beneficiaries eligible for CR and sites billing for CR services, and to calculate CR utilization rates within 12 months of beneficiaries’ qualifying event, including by Census Division and hospital referral region (HRR). Analyses included all FFS beneficiaries who were continuously enrolled in 2013 and 2014, eligible for CR services in 2013, and alive for at least 30 days post-qualifying event.
Results: Approximately 450,000 FFS beneficiaries had an event in 2013 that made them eligible for CR, with only 20% utilizing CR services. HRRs in the East South Central and West South Central divisions tended to have the greatest need for CR services (mean: 14.7 and 14.5 eligible beneficiaries per 1000 beneficiaries, resp.), but tended to have the least access to CR (mean: 5.9 and 6.0 CR sites per 1000 eligible beneficiaries, resp.) and the lowest utilization rates (mean: 14.3% and 15.3%, resp.) (Figure), suggesting areas for potential targeted intervention. Alternatively, HRRs in the West North Central division tended to have the most CR sites (mean: 16.8 CR sites per 1000 eligible beneficiaries) and the highest utilization rates (mean: 33.7%).
Conclusions: Limited access to CR services may contribute to suboptimal uptake of CR among eligible Medicare FFS beneficiaries. This study provides foundational information confirming the widespread need for CR services and identifies geographic areas where the need for CR is incongruent with the number of sites providing these services.
Author Disclosures: J. McNeely: None. M.D. Ritchey: None. S. Maresh: None. L. Schieb: None. J. Lloyd: None. T. Chang: None. E. Taylor: None. J. Wright: None.
- © 2016 by American Heart Association, Inc.