Congestive Heart Failure and Cardiac Rehabilitation

Cardiac Rehab programs now open to heart failure patients

 

Many who could benefit from attending cardiac rehabilitation didn’t have a coverable diagnosis. Yes they had significant heart disease with congestive heart failure, but were not covered to attend rehabilitation. For many years I assisted in fighting to get this coverage. It is wonderful to see it finally here. This opens access to many patients who would benefit from exercise, lifestyle intervention, education, prevention and managing of their chronic heart disease.

Congestive Heart Failure Patients finally Get Cardiac Rehabilitation

Congestive Heart Failure Patients finally Get Cardiac Rehabilitation

This is great news. I worked for many years petitioning our Congress and Senate to urge CMS to cover Cardiac Rehabilitation services for Congestive Heart Failure patients. There is a large subset of patients who can be much better served and monitored through cardiac rehabilitation to prevent readmissions. Congratulations to the AACVPR for helping attain this coverage from CMS, that is a very big deal.

 

 

 

WASHINGTON — Medicare has proposed covering cardiac rehabilitation services for patients with chronic heart failure 4 years after saying there was little evidence to support doing so.

The proposed coverage decision would expand access to rehab for a wider range of heart patients. Medicare currently covers rehab only for patients who have had an acute MI in the preceding year, coronary artery bypass surgery, heart or heart-lung transplant, or other major events.

The Centers for Medicare and Medicaid Services (CMS) came to the determination after reviewing literature on the rehab service from 2006 to August 2013. It announced the decision online late last week.

“Since chronic heart failure often results from coronary artery disease and hypertension, evidence on behavioral interventions in the treatment of these conditions provide additional supportive evidence,” the agency wrote. “With the accumulated evidence that supports the benefits of the individual components of cardiac rehabilitation programs, the evidence is sufficient to determine that participation in these multi-component programs improves health outcomes for Medicare beneficiaries with chronic heart failure.”

The agency is seeking public comments on the proposed decision and will post a final determination later.

Under the proposal, the agency would pay for rehab services — exercise, behavioral risk factor reduction, health education, and personal counseling — for patients with left ventricular ejection fraction of 35% or less and New York Heart Association class II to IV symptoms with at least 6 weeks of heart failure therapy.

The American Heart Association praised the CMS announcement.

“We are gratified that the agency recognized the evidence that pointed to the need for this expansion, and look forward to the day when this coverage will enable millions of heart failure patients to reap the benefits of cardiac rehabilitation,” AHA President Mariell Jessup, MD, said in a statement.

The AHA, along with the American College of Cardiology, the American Association of Cardiovascular and Pulmonary Rehabilitation, and the Heart Failure Society of America had asked CMS to consider adding CHF for coverage of cardiac rehab.

The CMS decision follows a study of nearly 2,300 patients that showed that aerobic exercise is safe for heart failure patients and effectively improves clinical outcomes. The patient population CMS is including is effectively the same as that in the trial, Ileana Pina, MD, professor at Albert Einstein College of Medicine in the Bronx, N.Y., told MedPage Today in a phone interview.

“Even though we knew all the good things exercise can do, a lot of physicians were not recommending it because the patients would have to pay out of pocket to go to a cardiac rehab program,” Pina, vice chair of the clinical cardiology council at the AHA, said.

She said many patients without this rehab option end up going to skilled nursing facilities because of their condition.

Roughly 17% of those age 65 and older have heart failure, according to CMS.

Resource for Heart Failure

http://www.heartfailurematters.org/EN/Warning-signs/Warning-signs

 

Below is some of the content from the above listed web site. It is a great resource for helping heart patients to understand the warning signs of heart failure and the actions to take. If you are a heart patient, or the significant other/caregiver take the time to review this site. It is important sometimes the symptoms sneak up on you.

 

 

Heart failure can be managed well with the right treatment and lifestyle adjustments, as recommended by your doctor or nurse. However, it is important to monitor all your symptoms on a regular basis as heart failure can progress slowly.

 

You can use the list on the left or any of the links below to learn more about the symptoms you should be monitoring and what to do if they get worse.

 

You should call for help immediately if you experience:

 

Persistent Chest pain that is not relieved by glyceryl trinitrate (GTN / nitroglycerin)

Severe and persistent shortness of breath

Fainting

 

You should inform your doctor as soon as possible if you experience:

 

Increasing shortness of breath

 

Frequent awakenings due to shortness of breath

 

Needing more pillows to sleep comfortably

 

Rapid heart rate or worsening palpitations

 

And you should discuss any of the symptoms below with your doctor or nurse.

 

Rapid weight gain

 

Progressive swelling or pain in the abdomen

 

Increased swelling of the legs or ankles

 

Loss of appetite/nausea

 

Increasing fatigue

 

Worsening cough

 

To help you monitor your symptoms, please click on the links below to find useful resources that you can download, print and fill in. You can then take these with you when you see your doctor or nurse and discuss your symptoms.

 

Symptom and event diary

 

Monitoring your heart failure chart

 

Warning signs leaflet

 

 

 

For a healthy heart eat a rainbow every day!

Fiber, vitamins, minerals, electrolytes, high nutrients, low-calorie, no artificial flavors or colors, natural sugars are part of a heart healthy diet and all easily available in a diet rich in colorful vegetables. If it is hard to get your servings of vegetables per day consider smoothies, chopping into small pieces adding small amounts to every meal you make. Ask yourself are you getting 4 1/2 cups a day of vegetables? Most will say no. Try new vegetables, search the internet for recipes.