{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:14:06Z","timestamp":1791670446292,"version":"4.3.4"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Cardiac rehabilitation (CR) reduces morbidity and mortality among individuals with heart disease. Although the COVID-19 pandemic disrupted health services, its impact on CR participation remains poorly understood\u2014especially among commercially insured populations, for whom CR utilization trends are poorly documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This cross-sectional time series study of enrollees aged 18 to 64 years with \u22651 CR-qualifying event (acute myocardial infarction, coronary artery bypass graft, heart valve repair\/replacement, percutaneous coronary intervention, or heart\/heart-lung transplant) during 2017 to 2022, with follow-up through 2023, used MarketScan commercial claims data. Adjusted analyses used Poisson log-linear models with robust standard errors to examine trends in enrollment and completion (\u226536 sessions), and generalized linear models with negative binomial distribution and log-link function to examine trends in days to enrollment and number of sessions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The sample included 143\u2009870 unique individuals aged 18 to 64 years with a CR-qualifying event. Of the sample, the mean age was 53.9 (SD, 8.1), and 70% were men. On average, from 2017 to 2023, enrollment was 24.2%, days to enrollment were 46.3 (SD, 51.4 days), the number of sessions was 13.9 (SD, 12.8), and completion was 9.6%. Compared with year 2017, 2020 was associated with a 12% lower prevalence of enrollment (adjusted prevalence ratio, 0.88 [95% CI, 0.85\u20130.90]), 6-day longer time to enrollment on average (adjusted difference, 6.04 [95% CI, 4.36\u20137.72]), 1.2 fewer sessions on average (adjusted difference, \u22121.24 [95% CI, \u22121.72 to \u22120.75]), and 13% lower prevalence of completion (prevalence ratio, 0.87 [95% CI, 0.78\u20130.97]). All metrics rebounded to prepandemic levels, except days to enrollment (4 days longer in 2022 versus 2017; adjusted difference, 3.78 [95% CI, 2.22\u20135.34]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Among commercially insured adults &lt;65 years, only one-quarter of eligible individuals participated in CR. CR metrics worsened during the COVID-19 pandemic in 2020, but most rebounded to prepandemic levels. These findings highlight an opportunity for health systems and public health initiatives to support broader CR uptake.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circoutcomes.125.012067","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T10:01:06Z","timestamp":1762768866000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiac Rehabilitation Trends Among Commercially Insured Adults in the United States, 2017\u20132023"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6659-3967","authenticated-orcid":true,"given":"Lisa M.","family":"Pollack","sequence":"first","affiliation":[{"name":"Division for Heart Disease and Stroke Prevention (L.M.P., A.C., H.S., H.K.W., L.S.S., S.L.J.), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0634-689X","authenticated-orcid":true,"given":"Lyudmyla","family":"Kompaniyets","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Physical Activity, and Obesity (L.K.), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2981-6030","authenticated-orcid":true,"given":"Anping","family":"Chang","sequence":"additional","affiliation":[{"name":"Division for Heart Disease and Stroke Prevention (L.M.P., A.C., H.S., H.K.W., L.S.S., S.L.J.), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9992-593X","authenticated-orcid":true,"given":"Michael P.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Michigan Medicine, Ann Arbor (M.P.T.)."},{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor (M.P.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Keteyian","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Henry Ford Health, Detroit, MI (S.J.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1635-894X","authenticated-orcid":true,"given":"Haley","family":"Stolp","sequence":"additional","affiliation":[{"name":"Division for Heart Disease and Stroke Prevention (L.M.P., A.C., H.S., H.K.W., L.S.S., S.L.J.), National Center for Chronic Disease Prevention and Health Promotion, 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