Abstract 18081: Using Evidence-Based Strategies, Including Coverage of Home-Based Cardiac Rehabilitation, to Increase Participation in Cardiac Rehabilitation - A Community Health Plan’s Experience

Abstract

Introduction: Barriers to referral, enrollment and participation in cardiac rehabilitation (CR) contribute to low rates of completion despite known benefits. Barriers are system, provider and patient related. We sought to examine the impact a non-integrated community health plan can have on addressing these barriers, given the absence of formal studies evaluating its impact. Hypothesis: Implementing evidence-based strategies would increase CR participation. Methods: Between October 2019-October 2022, The Capital District Physicians’ Health Plan (CDPHP) developed and implemented an enhanced cardiac rehabilitation initiative (ECRI) to increase CR rates using evidence-based strategies. CDPHP: 1) eliminated patient cost-share, 2) covered home-based cardiac rehabilitation (HBCR), 3) implemented physician valued-based incentives, 4) presented metrics to providers, 5) educated providers and patients, and 6) dedicated staff to facilitating enrollment. CR rates were evaluated between Q2 2021 and Q2 2022. Results: Time from ECRI program conception to implementation was 18 months. Enrollment in HBCR went from 4% (19/485) (Q2, 2021) to 7.8% (33/422) (Q2, 2022). Enrollment in center-based cardiac rehab (CBCR) went from 11% (53/485) to 11.4% (48/422) respectively. Total enrollment in CR increased from 14.8% (72/485) to 19.2% (81/422). Conclusions: The ECRI created a call-to-action among providers to address modifiable barriers such as patient identification for CR and referral and enrollment processes. The introduction of HBCR increased CR rates and were additive to CBCR rates, suggesting the introduction of HBCR can increase CR rates and not displace CBCR. Increasing CR engagement and amplifying the results found in this demonstration, requires coordinated effort from all stakeholders-cardiology providers, hospitals, CR providers and health plans.