Enspire Quality Partners has been selected by the Centers for Medicare & Medicaid Services (CMS) as one of 516 awardees in 47 states, Puerto Rico, and the District of Columbia to help reduce the risk of heart attacks and strokes among millions of Medicare fee-for-service beneficiaries. Health care practitioners, such as Enspire Quality Partners, participating in the Million Hearts® Cardiovascular Disease Risk Reduction Model will work to decrease cardiovascular disease risk by assessing an individual patient’s risk for heart attack or stroke and applying prevention interventions.
Enspire Quality Partners is a clinically integrated health network of physicians formed in collaboration with Med Center Health, and is the only participant chosen in the Bowling Green area. “We are proud to be a part of this new initiative,” said Cardiologist Kalidas Sahetya, M.D., chairman of the Enspire Quality Partners Board of Managers, “and we look forward to working with CMS and in cooperation with Med Center Health to develop better care models. Identifying high risk patients and working with them through the Million Hearts model will help save lives in our community.”
According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death and a major contributor to disability in the United States. One in three deaths are caused by heart attacks and strokes, resulting in over $300 billion of health care costs each year. Currently, health care practitioners are paid to screen for blood pressure, cholesterol, or other risk factors individually. In testing a new approach, practitioners participating in the Million Hearts® Cardiovascular Disease Risk Reduction Model’s intervention group will use a data-driven, widely accepted predictive modeling approach to generate personalized risk scores and develop specific plans in partnership with patients to reduce the risk of having a heart attack or stroke. Accepted applicants were randomly assigned to either the intervention or control group in accordance with the model’s randomized control design.
Overall, nearly 20,000 health care practitioners and over 3.3 million Medicare fee-for-service beneficiaries will participate in the five-year model. Enspire Quality Partners is participating in the intervention group and will work with Medicare fee-for-service beneficiaries to determine their ten-year individual risk for a heart attack or stroke. Enspire Quality Partners will then work with beneficiaries individually to identify the best approach or approaches to reducing their risk of having a heart attack or stroke – for example, smoking cessation interventions, blood pressure management, or cholesterol-lowering drugs or aspirin – and will explain the benefits of each approach. Each beneficiary will receive a personalized risk modification plan that will target their specific risk factors. Enspire Quality Partners will be paid for reducing the absolute risk for heart disease or stroke among their high-risk beneficiaries.
“Our health care system historically often emphasized acute care over preventive care,” said Dr. Patrick Conway, CMS Acting Principal Deputy Administrator and Chief Medical Officer. “This initiative will enhance patient-centered care and give practitioners the resources to invest the time and staff to address and manage patients who are at high risk for heart attacks and strokes.”
The Affordable Care Act, through the creation of the CMS Innovation Center, allows for the testing of innovative payment and service delivery models, such as the Million Hearts® Cardiovascular Disease Risk Reduction Model, to move our health care system toward one that spends dollars more wisely, delivers better care and makes individuals and communities healthier. This announcement is part of the Administration’s broader strategy to improve the health care system by paying practitioners for what works, unlocking health care data, and finding new ways to coordinate and integrate care to improve quality. In March 2016, the Administration announced it reached its goal, nearly one year ahead of schedule, of tying 30 percent of Medicare payments to alternative payment models that reward the quality of care over the quantity of services provided to beneficiaries.
This model is part of Million Hearts®, a broad national initiative co-led by CMS and CDC to prevent one million heart attacks and strokes by 2017. Million Hearts® brings together communities, health systems, nonprofit organizations, federal agencies, and private-sector partners from across the country to fight heart disease and stroke. For more information on the Million Hearts® initiative, please visit: https://millionhearts.hhs.gov.
For additional information about the Million Hearts® Cardiovascular Risk Reduction Model, including a fact sheet and a list of participants, please visit: https://innovation.cms.gov/initiatives/Million-Hearts-CVDRRM/.