{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:09:48Z","timestamp":1788876588994,"version":"build-2803163510"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cardiac rehabilitation (CR) can improve cardiovascular health. We identified whether CR participation was associated with fewer subsequent inpatient hospitalizations and emergency department visits and less Medicare and out\u2010of\u2010pocket expenditures, and whether outcomes varied by amount of participation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This retrospective study used Medicare fee\u2010for\u2010service claims data, including beneficiaries with a CR\u2010qualifying event in 2016. Participants attended \u22652 sessions of CR within 365\u2009days of the event. Propensity score matching was used to identify CR\u2010eligible nonparticipants. Difference\u2010in\u2010differences analyses were used to compare differences in outcomes before (2014\u20132015) and after (2018\u20132019; 2\u2010year CR period=2016\u20132017) the CR period between participants and nonparticipants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">We identified 57\u2009668 CR\u2010eligible beneficiaries after matching, with equal numbers of participants and nonparticipants. Nearly 65% of beneficiaries had a percutaneous coronary intervention, 33.5% had an acute myocardial infarction, 17.5% had a coronary artery bypass graft, and 16.8% had a heart valve repair\/replacement. Compared with nonparticipants, participants had 47.6 fewer subsequent annual inpatient hospitalizations per 1000 beneficiaries (95% CI, \u221258.8 to \u221236.3) and $1005 lower subsequent annual Medicare expenditures per beneficiary (95% CI, \u2212$1352 to \u2212$659). Compared with no participation, medium participation (12\u201323 sessions), high participation (24\u201335 sessions), and CR completion (\u226536 sessions) were associated with fewer inpatient hospitalizations and lower Medicare expenditures per year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">CR was associated with fewer subsequent annual inpatient hospitalizations and lower subsequent annual Medicare expenditures. A higher amount of participation was associated with a further reduction in hospitalizations and expenditures. These findings can inform programs and policies that encourage CR participation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.037811","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T05:07:31Z","timestamp":1740373651000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Health Care Use and Expenditures Associated With Cardiac Rehabilitation Among Eligible Medicare Fee\u2010for\u2010Service Beneficiaries"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6659-3967","authenticated-orcid":false,"given":"Lisa M.","family":"Pollack","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2981-6030","authenticated-orcid":false,"given":"Anping","family":"Chang","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3432-6466","authenticated-orcid":false,"given":"Jun Soo","family":"Lee","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Shaffer","sequence":"additional","affiliation":[{"name":"Center for Medicare & Medicaid Innovation, Centers for Medicare & Medicaid Services","place":["Baltimore, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6088-0706","authenticated-orcid":false,"given":"Hilary K.","family":"Wall","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clinton A.","family":"Brawner","sequence":"additional","affiliation":[{"name":"Henry Ford Health","place":["Detroit, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9992-593X","authenticated-orcid":false,"given":"Michael P.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Michigan Medicine","place":["Ann Arbor, USA"]},{"name":"University of Michigan","place":["Ann Arbor, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Keteyian","sequence":"additional","affiliation":[{"name":"Henry Ford Health","place":["Detroit, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4709-3390","authenticated-orcid":false,"given":"Devraj","family":"Sukul","sequence":"additional","affiliation":[{"name":"University of Michigan Health","place":["Ann Arbor, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7132-2854","authenticated-orcid":false,"given":"Feijun","family":"Luo","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4810-0572","authenticated-orcid":false,"given":"Sandra L.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","unstructured":"About Million Hearts\u00ae 2027 . Million Hearts\u00ae. Accessed September 7 2022. https:\/\/millionhearts.hhs.gov\/about\u2010million\u2010hearts\/index.html."},{"key":"e_1_3_2_3_2","unstructured":"42 c.F.R 410.49 cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage. Accessed April 14 2024. https:\/\/www.ecfr.gov\/current\/title\u201042\/chapter\u2010IV\/subchapter\u2010B\/part\u2010410\/subpart\u2010B\/section\u2010410.49."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.10.044"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.4032"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.066738"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2014.02.008"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.01.078"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0000000000000835"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2005.tb07121.x"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.10.040"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.05.010"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000121360.31954.1F"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000066322.21016.4A"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1444-2892.2002.00105.x"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(91)90870-q"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/2047487314535076"},{"key":"e_1_3_2_18_2","unstructured":"Centers for Medicare & Medicaid Services . Decision memo for cardiac rehabilitation programs\u2014chronic heart failure. Cag\u201000437n. Accessed August 29 2022. https:\/\/www.cms.gov\/medicare\u2010coverage\u2010database\/view\/ncacal\u2010decision\u2010memo.aspx?proposed=N&NCAId=270."},{"key":"e_1_3_2_19_2","unstructured":"Million Hearts\u00ae Cardiac Rehabilitation Collaborative Surveillance Workgroup members . Million hearts\u00ae outpatient cardiac rehabilitation use surveillance methodology (may 2024). 2024. Accessed March 6 2023. https:\/\/millionhearts.hhs.gov\/files\/Cardiac\u2010Rehab\u2010Use\u2010Surveillance\u2010Guidance\u2010508.pdf."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0000000000000675"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.005902"},{"key":"e_1_3_2_23_2","unstructured":"Cardiac rehabilitation programs. Accessed July 3 2023. https:\/\/www.medicareinteractive.org\/get\u2010answers\/medicare\u2010covered\u2010services\/rehabilitation\u2010therapy\u2010services\/cardiac\u2010rehabilitation\u2010programs."},{"key":"e_1_3_2_24_2","unstructured":"National Committee for Quality Assurance . Cardiac rehabilitation: a new hedis measure for heart health. Accessed September 14 2022. https:\/\/www.ncqa.org\/blog\/cardiac\u2010rehabilitation\u2010a\u2010new\u2010hedis\u2010measure\u2010for\u2010heart\u2010health\/."},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12612"},{"key":"e_1_3_2_26_2","unstructured":"Data Sources . Centers for Disease Control and Prevention Division for Heart Disease and Stroke Prevention. Accessed October 5 2022. https:\/\/www.cdc.gov\/dhdsp\/maps\/atlas\/data\u2010sources.html."},{"key":"e_1_3_2_27_2","unstructured":"Centers for Medicare & Medicaid Services (CMS) . Chronic conditions data warehouse. Accessed September 6 2022. https:\/\/www2.ccwdata.org\/web\/guest\/condition\u2010categories\u2010chronic."},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_3_2_29_2","unstructured":"Pope GC Ellis RP Ash AS Ayanian JZ Bates DW Burstin H Iezzoni LI Marcantonio E B W. Diagnostic cost group hierarchical condition category models for medicare risk adjustment. 2000 https:\/\/www.cms.gov\/research\u2010statistics\u2010data\u2010and\u2010systems\/statistics\u2010trends\u2010and\u2010reports\/reports\/downloads\/pope_2000_2.pdf."},{"key":"e_1_3_2_30_2","first-page":"119","article-title":"Implementation of risk adjustment for medicare","volume":"21","author":"Ingber MJ","year":"2000","unstructured":"Ingber MJ. Implementation of risk adjustment for medicare. Health Care Financ Rev. 2000;21:119\u2013126.","journal-title":"Health Care Financ Rev"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2015.05.015"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.330.7497.960"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-040617-013507"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.16153"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2302291"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/ectj\/utac010"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001800.pub4"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2016.10.014"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/1559827616670118"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2016.12.024"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.876383"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.11124\/JBIES-21-00457"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2022.01.003"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0000000000000547"},{"key":"e_1_3_2_46_2","unstructured":"Centers for Disease Control and Prevention . Million Hearts\u00ae cardiac rehabilitation change package. Accessed August 28 2023. https:\/\/millionhearts.hhs.gov\/tools\u2010protocols\/action\u2010guides\/cardiac\u2010change\u2010package\/index.html."},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0000000000000634"},{"key":"e_1_3_2_48_2","unstructured":"Distribution of Medicare Beneficiaries by Race\/Ethnicity . KFF. Accessed July 6 2023. https:\/\/www.kff.org\/medicare\/state\u2010indicator\/medicare\u2010beneficiaries\u2010by\u2010raceethnicity\/?currentTimeframe=0&selectedRows=%7B%22wrapups%22:%7B%22united\u2010states%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22 %22sort%22:%22asc%22%7D."},{"key":"e_1_3_2_49_2","unstructured":"ASPE . Medicare beneficiary enrollment trends and demographic characteristics. Accessed July 6 2023. https:\/\/aspe.hhs.gov\/reports\/medicare\u2010enrollment."},{"key":"e_1_3_2_50_2","unstructured":"Murphy\u2010Barron C Pyenson B Ferro C Emery M. Comparing the demographics of enrollees in medicare advantage and fee\u2010for\u2010service medicare. 2020. Accessed August 6 2024. https:\/\/bettermedicarealliance.org\/wp\u2010content\/uploads\/2020\/10\/Comparing\u2010the\u2010Demographics\u2010of\u2010Enrollees\u2010in\u2010Medicare\u2010Advantage\u2010and\u2010Fee\u2010for\u2010Service\u2010Medicare\u2010202010141.pdf."},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0000000000000659"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.focus.2023.100089"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.037811","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T13:36:34Z","timestamp":1788874594000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.037811"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,4]]},"references-count":51,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,3,4]]}},"alternative-id":["10.1161\/JAHA.124.037811"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.037811","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,4]]},"assertion":[{"value":"2024-09-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e037811"}}