Million Hearts Cardiovascular Disease Risk Reduction Model
To better understand the efficacy of the Million Hearts Model, CMS developed the Million Hearts Cardiovascular Disease Risk Reduction Model, a randomized controlled trial focused on Medicare beneficiaries. Launched in 2017, the five-year evaluation aims to inform decision-making about scaling the model by assessing if and how Million Hearts interventions improve cardiovascular disease care, reduce heart attacks and strokes, and reduce spending.5
516 organizations were divided between an intervention group, who were tasked with implementing the ASCVD risk calculator (detailed below) and other evidence-based interventions, and a control group, who did not change their practices but submitted data to CMS for comparison. Initial findings suggest favorable effects of the Million Hearts model on the delivery of CVD preventive care and prescription adjustment, reduction of risk scores among high-risk patients, and fatality reductions among medium and high risk beneficiaries.6
ASCVD 10-Year Risk Calculator & Impact of Comorbidities
A tool heavily employed in Million Hearts efforts, the Atheroscledrotic Cardiovascular Disease (ASCVD) 10-Year Risk Calculator estimates a patient’s risk of having a cardiovascular event within 10 years, based on demographic data and patient health history. The American College of Cardiology and the American Heart Association encourage providers to use the tool with patients to develop prevention and treatment plans.
The ASCVD calculator takes into account several comorbidity indicators, including history of diabetes, hypertension treatment status, and tobacco use history, to predict patient cardiovascular risk. Leveraging claims data, we are able to clearly see the compounding effects of these and other cardiovascular-related comorbidities on history of heart attack and stroke, as shown in the charts below.
Heart Attack & Stroke Prevalence by Comorbidity Count, All Beneficiaries, 2019
Comorbidities considered: CHF, Hypertension, Ischemic Heart Disease, Diabetes, Asthma